Umarnin Acarbose don masu ciwon sukari nau'in 1 da 2, analogues

Wakilin bakin mahaifa, yana hana hanzarin alpha-glucosidase, rage haɓakar enzymatic na di-, oligo- da polysaccharides zuwa monosaccharides, don haka rage shayewar glucose daga hanji da kuma postprandial hyperglycemia. A cikin marasa lafiya da ke fama da rashin haƙuri na rashin ƙarfi, yin amfani da kullun yana rage haɗarin haɓaka nau'in mellitus na sukari na 2 (wanda ya haɗa gwargwadon makahon-sau biyu, STbo-N> binciken sarrafawa.

Tare da yin amfani da acarbose, haɓakar ƙwayar cuta abu ne wanda ba a bayyana shi ba. Koyaya, haɗin gwiwar miyagun ƙwayoyi tare da sauran wakilai na hypoglycemic ko insulin na iya haifar da irin wannan sakamako, saboda haka amfani da irin wannan haɗuwa ba ta da umarnin WHO. Hakanan an gano cewa alamun hypoglycemia yana tasowa lokacin da tsofaffi da mutane masu rauni suka yi amfani da acarbose, koda kuwa ba a yi amfani da wasu magungunan maganin antidiabet a lokaci guda ba, wanda kuma yakamata a yi la’akari da lokacin da ake rubuta magunguna ga marasa lafiyar waɗannan rukunin.

A karatu a cikin vitro da a cikin vivo babu shaidar mutagenicity. Gudanarwa da berayen tare da abinci baya shafar haihuwa da kuma ikon haihuwa gaba ɗaya.

Shirya magunguna

Oradewa - kusan 35% na kashi na sarrafawa, mai yiwuwa a cikin hanyar metabolites (wanda 2% - a cikin aiki), bioavailability shine 1-2%. Bayan gudanar da baki, ana lura da kololuwa na hankali biyu: bayan sa'o'i 1-2 da kuma bayan sa'o'i 14 zuwa 14, bayyanar mafi girma na biyu ya kasance ne saboda shafar metabolites daga hanji. Volumearar rarraba - 0.39 l / kg. A cikin marasa lafiya da gazawar renal (keɓantar da keɓaɓɓen kasa da 25 ml / min. / 1.73 m²), matsakaicin maida hankali (C_max) yana ƙaruwa sau 5, a cikin tsofaffi - sau 1.5.

Yana cikin metabolized na musamman a cikin jijiyoyin ciki, galibi kwayoyin cuta na hanji da kuma gishirin narkewa a ciki, tare da samuwar kwatankwacin akalla 13. An gano babban metabolites azaman asalin abubuwa na 4-methylpyrogallol (a cikin nau'in sulfate, methyl da glucuronic conjugates). Metabolaya daga cikin metabolite, samfurin kayan aikin glucose a cikin acarbose, yana da ikon hana alpha glucosidase.

Rabin rayuwa T_1/2 ) a cikin rarraba - 4 hours, a cikin lokaci na excretion - sa'o'i 10. An keɓance ta cikin hanji - 51% (a cikin awanni 96) kamar yadda samfuran metabolism (acarbose wanda ba a san shi ba), ta hanyar kodan - 34% a cikin hanyar metabolites kuma ƙasa da 2% - canzawa kuma azaman metabolite mai aiki.

Manuniya Shirya

Nau'in sukari na 2 na ciwon sukari (tare da rashin ingancin maganin rage cin abinci, wanda yakamata ya zama aƙalla watanni 6, ƙarancin ingantaccen ƙididdigar abubuwan da suka dace na maganin ƙwaƙwalwar mayuka), nau'in ciwon sukari na 1 mai nau'in ciwon sukari (nau'in maganin haɗuwa). Yin rigakafin nau'in ciwon sukari na 2 na marasa lafiya (a cikin marasa lafiya da raunin glucose mai rauni a hade tare da abinci da motsa jiki).

Contraindications Shirya

Hypersensitivity, ciwon sukari ketoacidosis, hanta cirrhosis, m da na kullum mai kumburi cututtukan hanji da rikitarwa da narkewa da cuta cuta (ciki har da malabsorption ciwo, maldigestion syndrome), Remgeld syndrome, babban hernia na ciki bango, gastrointestinal fili pathology tare da karuwar iskar gas, I , toshewar hanji (gami da juzu'ai ko sanya shi a ciki), tsaurara da raunin hanji, gazawar koda na ciki (abun da ke jikin sama da 2 m / Dl), ciki, lactation.

Sakawa Regimen

Ana ɗaukar miyagun ƙwayoyi a baki, ba tare da tauna ba, tare da ɗan ƙaramin ruwa nan da nan kafin cin abinci ko awa 1 bayan cin abinci. Kashi na farko shine 50 mg times sau 3 a rana tare da karuwa a hankali zuwa kashi daya zuwa 100-200 MG (ana kara yawan kashi ne bayan makonni 4-8 na maganin tare da tazara tsakanin makonni 1-2, gwargwadon glycemia da kuma haƙuri na mutum). Matsakaicin matsakaici a cikin manya tare da nauyin jikin ƙasa da kilogram 60 shine 50 MG, fiye da kilogiram 60 shine 100 mg times sau 3 a rana. Matsakaicin adadin yau da kullun shine 600 MG.

Rigakafin: Na farko kashi - 50 MG 1 sau ɗaya kowace rana tare da karuwa a hankali a cikin kashi ɗaya zuwa 100 MG (ana aiwatar da haɓaka kashi don watanni 3).

Gefen Hanyar Gyara

Tunda acarbose yana hana rushewar takaddun carbohydrates zuwa glucose, wani adadin carbohydrates din ya rage a cikin hanji kuma ana ba da shi ga masara. A cikin kwayar cuta, ƙwayoyin cuta suna narke hadaddun carbohydrates, suna haifar da sakamako masu illa kamar hancin ciki (78% na marasa lafiya) da zawo (14% na marasa lafiya). Tunda waɗannan tasirin suna dogara da kashi, ana bada shawara koyaushe tare da ƙarancin kashi kuma sannu a hankali ƙara yawan zuwa matakin da ake so. Studyaya daga cikin binciken ya nuna cewa sakamako masu illa na gastrointestinal sun ragu sosai (daga 50% zuwa 15%) a cikin makonni 24, har ma da amfani na yau da kullun.

Idan mai haƙuri da ke amfani da acarbose ya sha wahala daga harin hypoglycemia, mai haƙuri ya kamata ya ci wani abu wanda ya ƙunshi monosaccharides, kamar Allunan glucose ko gel (GlucoBurst, Insta-Glucose, Glutose, Level One), kuma ya kamata a kira likita. Saboda acarbose yana toshe sanadiyar sukari tebur da sauran hadaddun sugars, ruwan 'ya'yan itace ko abinci mai tsayayye ba zai iya jujjuya yanayin bugun jini a cikin haƙuri mai shan acarbose ba.

An ba da rahoton hepatitis ta amfani da acarbose. Yawancin lokaci yakan ɓace lokacin da aka dakatar da maganin. Saboda haka, ya kamata a bincika enzymes na hanta kafin da lokacin amfani da wannan magani.

GIT: zafin epigastric, flatulence, tashin zuciya, zawo, da wuya - karuwar ayyukan “hanta” transaminases (lokacin da aka ɗauka a kashi na 150-300 mg / rana), toshewar hanji, jaundice, hepatitis (a lokuta mafi ƙaranci, cikawa tare da mutuwa).

Bayani na musamman Shirya

Manyan hanyoyin tiyata da raunin da ya faru, konewa mai yawa, cututtuka masu yaduwa tare da cututtukan febrile na iya buƙatar dakatar da magunguna na baka da maganin insulin. Wajibi ne a bi tsarin abinci sosai. Abinci da abinci mai ɗauke da ƙwayoyin carbohydrates mai yawa (poly-, oligo-, disaccharides) na iya haifar da rikicewar hanji. Ya kamata a gudanar da magani a ƙarƙashin ikon glucose a cikin jini da / ko fitsari na glycosylated Hb da transaminases a farkon shekarar magani - sau ɗaya a kowane watanni 3 sannan kuma lokaci-lokaci. Doseara yawan ƙwayar cutar fiye da 300 mg / rana yana haɗuwa tare da raguwa mai sauƙi a cikin postprandial hyperglycemia tare da karuwa a lokaci daya cikin hadarin hyperfermentemia. Tare da gudanar da magunguna na lokaci guda - abubuwan da aka samo na maganin sulfonylurea ko tare da insulin, haɓakar ƙwayar tsoka zai yiwu, wanda aka gyara ta ƙara glucose a cikin abinci, ko ta hancin sarrafawa. Idan ana cikin matsalar rashin ƙarfi na hypoglycemia, ya kamata a ɗauka a zuciya cewa sukari abinci ya karye cikin glucose da fructose, wanda insulin ɗin baya sarrafa shi saboda haka sucrose bai dace da saurin saukewar hawan jini ba. Don cire shi, yana da kyau a yi amfani da ko dai glucose a cikin manyan allurai ko glucagon (a mawuyacin hali).

Shirya hulɗa

Abubuwan da suka samo asali na sulfonylureas, insulin, metformin suna inganta tasirin hypoglycemic. Antacids, colestyramine, adsorbents na hanji, magungunan enzyme suna rage tasiri. Thiazide diuretics, corticosteroids, phenothiazines, hormones thyroid, estrogens, maganin hana daukar ciki, phenytoin, acid nicotinic, adrenostimulants, BMKK, isoniazid da sauran magungunan da ke haifar da hauhawar jini, da muhimmanci rage yawan aiki (zai yiwu a lalata cututtukan sukari).

Alamu don amfani

Acarbose an wajabta wa marassa nauyi da ke ɗauke da nau'in 1 ko nau'in ciwon sukari 2, da kuma na waɗanda ke cikin masu fama da ciwon sukari kuma waɗanda ke da rigakafin yin allurar insulin.

Abilityarfinsa na rasa nauyi an tabbatar dashi ta hanyar kimiyya, saboda haka za'a iya tsara maganin don kiba, ciwon sukari mai haɗari. Acarbose an wajabta wa masu ciwon sukari da ke yin aiki na jiki, maimakon magunguna na tushen sulfonylurea, tunda ƙarshen a mafi yawan lokuta suna haifar da ƙin jini.

Fom ɗin saki

Acarbose farar farar fata ce (inuwa mai haske tana yiwuwa), wacce take narkewa cikin ruwa. A cikin kantin magunguna, ana fitar dashi a cikin nau'ikan allunan, tare da sashi na 50 da 100 MG.

Shahararrun samfuran Acarbose sune Jamusancin “Glucobay” da Baturke “Alumina”. Matsakaicin farashin na farkon shine kusan 490 rubles don allunan 30 tare da sashi na 50 MG. Magungunan "Glinoza" ba a samo shi ba a cikin tsarin magunguna na Rasha kwanan nan.

Dangane da sashi, Glucobai ya ƙunshi 50 na 100 na acarbose. Tasirin warkewa yana faruwa a cikin jijiyar ciki. Yana rage jinkirin ayyukan wasu enzymes waɗanda ke da hannu cikin rushewar polysaccharides.

Daga cikin ƙarin abubuwan haɗin: silicon dioxide, magnesium stearate, sitaci masara, celclose microcrystalline.

Umarnin don amfani

Ana ɗaukar maganin a baki sau 15-20 kafin cin abinci. Za a iya ci bayan cin abinci. A wannan yanayin, zai zama dole a jira akalla sa'a guda.

An saita sashi ne ta hanyar likita daban-daban ga kowane mara lafiya, dangane da yanayin lafiyar sa, tsananin tsananin cutar sankara, kasancewar cututtukan concomitant.

A matsayinka na mai mulki, a farkon matakin, an wajabta cin abinci sau uku na 50 MG. Idan bayan watanni 1-2 ba a gano sakamako masu illa ba, sashi yana ƙaruwa.

Ya halatta a ɗauki fiye da 600 mg na acarbose kowace rana. Tsawan lokacin jiyya ya kamata aƙalla watanni shida.

Siffofin aikace-aikace

Acrebose-based kwayoyi suna contraindicated don amfani da yara da matasa a karkashin 18 shekara. Hakanan an ba da shawarar don tsawon lokacin maganin don ware barasa a kowane nau'i saboda cikakken rashin daidaituwa tare da kayan aiki mai aiki.

Tsofaffi marasa lafiya, da kuma mutanen da ke da cututtukan hanta da koda, an ba su damar amfani da maganin. Ba a buƙatar gyaran fuska ba, an zaɓi shi ne gwargwadon ƙarfin cutar ciwon sukari da amsawar jiki ga maganin.

An haramta Acarbose a duk tsawon lokacin daukar ciki da lactation saboda karancin shaidar kimiyya game da amincin sa ga tayin.

Yin hulɗa tare da wasu kwayoyi

Magungunan Acarbose na haɓaka aikin metformin, insulin, sulfonylurea, don haka yana ba da gudummawa ga ci gaban hauhawar jini.

Daga cikin magungunan da ke raunana tasirin magani, masu zuwa:

• hodar iblis,
• steroidal anti-mai kumburi magunguna,
• kamuwa da cuta
• hana haihuwa
• magunguna dauke da acid nicotinic.

Haɗin gwiwa na maganin cututtukan cututtukan mahaifa da sihirin ba su da tasiri saboda raunin raunin warkewar ƙarshen ƙarshen.

Side effects

Magunguna da aka dogara da acarbose na iya haifar da amsawar jiki mara amfani ga ilimin. Mafi sau da yawa fiye da wasu taso:

• matsanancin gas, zazzabi, jin zafi a ciki,
• cikakke ko naƙasa na hanji,
• haɓaka enzymes hanta.

Daga fata, amya, rashes na iya bayyana.

A matsayinka na mai mulki, an yarda da maganin sosai. Abubuwan da ba a so ba suna bayyana ne kawai a farkon kwanakin aikin warkaswa kuma suna wuce kansu. Dose daidaituwa da takamaiman magani ba a buƙatar.

Koyaya, tsawon lokacin maganin acarbose, an shawarci marasa lafiya da suyi binciken jini akai-akai don yawan enzymes na hanta don gujewa ci gaban hepatitis.

Contraindications

Contraindications don ɗaukar acarbose za'a iya rarrabasu bisa ƙa'idodi cikin cikakke kuma dangi.

A cikakkar wadanda sun hada da:

• ciki
• lactation
• cirrhosis
• ketoacidosis
• na kullum na koda,
• rashin jituwa ga kowane bangare na miyagun ƙwayoyi.

Daga cikin dangi, zamu iya bambanta:

• yanayin zazzabi
• kamuwa da cuta bayan hanyoyin tiyata.

Yana da mahimmanci a lura cewa likitan halartar ne kawai zasu iya yanke shawara ta ƙarshe akan maganin acarbose.

Yawan damuwa

Idan maganin da aka tsara ya wuce, zazzabin cizon sauro na iya bayyana. A wannan yanayin, mai haƙuri dole ne ya ƙi abincin da ke ɗauke da carbohydrates na akalla 5 hours.

Irin wannan alamu na iya faruwa lokacin cinye dumbin carbohydrates a yayin aikin jiyya.

Idan an hada acarbose a hade tare da sauran magunguna masu rage sukari, to matsalar hawan jini na kara yawa. Wani nau'i mai laushi na irin wannan rikicewar ya tsaya ta hanyar abincin carbohydrate. Tsarin matsakaici da tsauraran yanayi suna buƙatar taimakon likita. Maganin da aka fi amfani dashi shine dextrose na ciki.

Daga cikin shirye-shiryen da aka yi dangane da acarbose, “Glucobay” na Jamusanci da Glinoza na Turkiyya suna wakiltar kasuwar Rasha. Latterarshen ya zama ƙasa da yawa a cikin sarƙoƙin kantin magani.

Magunguna na tushen Metformin suna da irin tasirin hypoglycemic. Shahararrun sunayen kasuwanci sune Glucophage da Siofor.

A wasu halaye, ana amfani da magunguna na tushen sulfonylurea: Gliclazide, Glibenclamide

Bayan shekaru 45, sukarin jinina ya fara ƙaruwa. Abincin abinci ba shi da tasiri. Likita ya ba da izini ga masu haila. Abubuwan da aka samo na metformin sun rage sukari sosai, sau ɗaya har ma sun kira motar asibiti. Yanzu na karɓi Acarbose. Na ji dadi, Ban riga na gano wani sakamako masu illa ba.

Hanyar cutar sankarata tana da tsawo. Na gwada magunguna da yawa. Wasu ba su dace ba nan da nan, wasu sun nuna illolin sakamako, bayan wani lokaci. Yanzu ina shan Glucobay. Ina mai farin ciki da farashin sa da kuma yadda yake sauƙin saukar da sukari a cikin jinina. Ina fatan ba shi da wani tasiri mara amfani a jikina.

Magungunan zamani ba su da ikon warkewa da ciwon sukari baki ɗaya. Babban aikinsu shi ne kiyaye matakan sukari tsakanin iyakokin da aka yarda kuma su guji kaifi mai kauri sama da ƙasa. Marasa lafiya masu ciwon sukari ya kamata su tuna da babban abinda - ba tare da tsayayyen abincin ba, babu magani da zaiyi aiki, komai yanayin zamani.

Menene acarbose kuma yaya yake aiki

Abubuwan carbohydrates a cikin abincinmu sune mafi yawancin hadaddun. Da zaran cikin narkewar abinci, sai su sha ruwa da ruwa tare da enzymes na musamman - glycosidases, bayan wannan sun lalata zuwa monosaccharides. Sauki mai sauƙi, bi da bi, ya shiga cikin mucosa na hanji ya shiga cikin jini.

Acarbose a cikin tsarinsa shine pseudosaccharide wanda aka samo ta hanyar ilimin halittu. Yana gasa tare da sugars daga abinci a cikin hanji na sama: ya ɗaura wa enzymes, yana hana su ikon ɗan lokaci su rushe carbohydrates. Sakamakon wannan, acarbose yana rage jinkirin gudanawar glucose a cikin jini. Mafi yawan saukakke kuma mafi daidaituwar glucose ya shiga cikin tasoshin, shine mafi kyawun cire shi daga gare su cikin kyallen. Glycemia ya zama ƙasa, sauyawarsa bayan an rage abinci.

Tabbatar Acarbose Tasiri:

1. Normalizes glycated haemoglobin, inganta diyya na ciwon sukari.
2. Tare da rayayyar data kasance a cikin haƙuri na 25% yana rage haɗarin haɓakar ciwon sukari.
3. Yana hana cututtukan zuciya: an rage haɗarin ta hanyar 24% a cikin masu ciwon sukari, da 49% a cikin marasa lafiya tare da NTG.

Acarbose ya fi tasiri a cikin marasa lafiya da al'ada glycemia na yau da kullun da haɓaka bayan cin abinci. Nazarin sun nuna cewa amfani da shi na iya rage glucose mai azumi da 10%, glucose bayan cin abinci da kashi 25%, glycated haemoglobin da kashi 21%, cholesterol by 10%, triglycerides by 13%.Tare da glycemia, maida hankali kan insulin a cikin jini yana raguwa. Saboda ƙananan abun ciki na insulin da lipids a cikin marasa lafiya da ciwon sukari, jinkirin insulin da haɗarin atherosclerosis, an sauƙaƙe asarar nauyi.

Anyi amfani da Acarbose a matsayin mai zubar da jini a cikin shekaru fiye da 20. A cikin Rasha, ƙwayoyi guda ɗaya kawai tare da wannan abu suna rijista - Glucobai daga kamfanin Jamus Jamus Pharma Pharma. Allunan suna da allurai 2 - 50 da 100 mg.

Amfani da Acarbose Glucobai don asarar nauyi

Lokacin ɗaukar acarbose, wasu daga cikin carbohydrates basu da lokaci don rushewa kuma an keɓe su daga jiki tare da feces, kuma an rage yawan adadin kuzari na abinci. Sun yi ƙoƙarin yin amfani da wannan kayan fiye da sau ɗaya don asarar nauyi, har ma an gudanar da bincike game da tasiri na miyagun ƙwayoyi don asarar nauyi. A cikin marasa lafiya da ciwon sukari, gabatarwar acarbose a cikin tsarin kulawa yana haifar da asarar nauyi na nauyin 0.4 kg. A lokaci guda, yawan caloric da yawan lodi sun kasance iri ɗaya.

Likita na Kimiyyar Kimiyya, Shugaban Cibiyar Nazarin Diabetology - Tatyana Yakovleva

Na yi shekaru da yawa ina nazarin ciwon sukari. Yana da ban tsoro yayin da mutane da yawa suka mutu, har ma da yawa suna zama masu rauni saboda cutar sankara.

Na yi hanzarin ba da labari mai daɗi - Cibiyar Binciken Endocrinological na Kwalejin Kimiyya ta Rasha ta sami nasarar haɓaka maganin da ke warkar da ciwon sukari gaba ɗaya. A yanzu, ingancin wannan magani yana gab da kashi 98%.

Wani albishir: Ma'aikatar Lafiya ta tabbatar da ɗaukar wani shiri na musamman wanda zai biya diyyar magunguna mai yawa. A Rasha, masu ciwon sukari har sai 18 ga Mayu (m) samun shi - Don kawai 147 rubles!

An kuma gano cewa amfani da Acarbose don asarar nauyi ya fi tasiri a hade tare da abinci da wasanni. A wannan karon, an gudanar da binciken ne cikin mutane masu lafiya. Sakamakon ya kasance mai ƙarfafawa: sama da watanni 5, marasa lafiya sun rage BMI ta 2.3, a cikin rukunin sarrafawa ba tare da acarbose ba - kawai 0.7. Likitocin sun ba da shawarar cewa wannan tasirin yana da alaƙa da sakamako masu illa na maganin. Da zaran sun rasa nauyi tare da carbohydrates, nan da nan sai su kara aiwatar da fermentation a cikin hanji, zazzabi ko zawo zai fara. Acarbose a nan yana aiki a matsayin nau'i na alamar abinci mai dacewa, kowane cin zarafin abincin yana cike da sakamako mara kyau.

Me za a iya maye gurbinsa

Glucobai bashi da cikakkiyar alamun analogues. Baya ga acarbose, ƙungiyar α-glucosidase inhibitors sun haɗa da abubuwa masu aiki kamar voglibose da miglitol. A kan tushen su, an kirkiro Diastabol na Jamusanci, Alumina na Baturke, Yukren Ukraine Voksid. Suna da sakamako iri ɗaya, don haka ana iya ɗaukar su analogues. A cikin kantin magunguna na Rasha, babu ɗayan waɗannan magungunan da aka gabatar, wanda ya sa masu ciwon sukari na cikin gida dole ne su kame kansu zuwa Glucobai ko kawo magungunan daga ƙasashen waje.

Acarbose ba a cikin jerin Magungunan Mahimmanci da Mahimmanci, don haka an tilasta wa marasa lafiya da ciwon sukari su sayi Glucobay da kansu. Farashin a Rasha ya tashi daga 500 zuwa 590 rubles. don 30 Allunan 50 na 50 MG. Sashi na 100 MG shine ɗan ƙara tsada: 650-830 rubles. iri daya ne.

A matsakaici, magani zai biya 2200 rubles. tsawon wata daya. A cikin kantin magunguna na kan layi, maganin yana da rahusa, amma a yawancin su zaku biya don bayarwa.

Neman Masu haƙuri

A cewar masu ciwon sukari, Glucobai magani ne "maras kyau". Ba a tilasta wa marasa lafiya kawai su bi tsarin karancin carb, amma a wasu yanayi don barin kayayyakin kiwo, tunda lactose na iya haifar da narkewar abinci. An kimanta sakamakon rage sukari na acarbose da kyau. Magungunan sun sami nasarar daidaita glucose bayan cin abinci, rage yawan canzawarsa da rana.

Binciken rasa nauyi ba su da kyakkyawan fata. Suna shan miyagun ƙwayoyi musamman hakori mai daɗi, wanda ba zai iya yin ba tare da kayan zaki ba na dogon lokaci. Suna samun waɗannan kwayoyin basu da lahani, amma masu tsada sosai. Bugu da ƙari, saboda tasirin sakamako, za a iya cin abincin carbohydrate a gida kawai, ba tare da tsoron sakamakon ba. Idan aka kwatanta da Xenical, Glucobay ya fi haƙuri, amma sakamakon sa yana da ƙasa da yawa.

Tabbatar koya! Shin kuna tsammanin kulawa da kwayoyin hana daukar ciki da insulin shine hanya daya tilo da za'a kula da sukari? Ba gaskiya bane! Kuna iya tabbatar da wannan da kanku ta hanyar fara amfani da shi. kara karantawa >>