Wani lokaci abinci na musamman da aikin jiki ba zai iya samar da matsakaicin 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.
Ta yin amfani da repaglinide akan masu karɓa na musamman, ana toshe hanyoyin tashoshin ATP da ke cikin membranes na sel. Irin wannan tsari yana tsokani ɓarkewar ƙwayoyin sel da buɗewar tashoshi na alli. A sakamakon haka, haɓakar insulin yana ƙaruwa ta hanyar ƙara yawan adadin ƙwayoyin haɗi.
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 sosai kuma ya zama kaɗan. Nazarin magungunan sun tabbatar da cewa babu wani bambanci mai mahimmanci a cikin ƙimar magunguna lokacin amfani da Repaglinide kafin ko lokacin abinci.
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 kafa metabolites marasa aiki. Ainihin, ana fesa su da bile, har da fitsari (8%) da feces (1%).
Mintuna 30 bayan shan 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 yawan-kumburi cikin 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 lamunin ya ƙunshi allunan 15; ana iya samun blister da yawa a cikin kunshin daya.
A cikin kowane kunshin na miyagun ƙwayoyi tare da bangaren fanshi, umarnin don amfani wajibi ne. An zabi sashi daban-daban ta hanyar kwararrun kwararru wadanda ke tantance matakin sukari da kuma abubuwan da ke tattare da mara lafiya. 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, wucewa gwaje gwaje gwaje-gwaje na 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 za a iya amfani da shi a kowane yanayi ba.
Contraindications da yiwuwar lahani
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:
- nau'in ciwon sukari da ke dogaro da kansa;
- cututtukan cututtukan ketoacidosis, gami da coma;
- mai tsanani hanta da / ko koda na ciki;
- ƙarin amfani da kwayoyi waɗanda ke haifar ko hana CYP3A4;
- rashin maganin lactose, rashi lactase da malambor-gluct-galactose malabsorption;
- susara yawan mai saukin kamuwa zuwa bangaren;
- a karkashin shekara 18;
- tsarawa ko ci gaba da ciki;
- nono.
Binciken da aka gudanar akan berayen sun tabbatar da cewa amfani da maganin repaglinide a lokacin haihuwar yaro yana cutar da tayin. Sakamakon maye, ci gaban babba da na ƙarshen tayin an tarwatsa su. 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, faruwar halayen masu haɗari kamar:
- halin hauhawar jini (karuwar gumi, rawar jiki, barcin mara kyau, tachycardia, damuwa);
- lalata abubuwa na gani (a farkon matakan shan maganin, sannan ya wuce);
- narkewa a ciki (ciwon ciki, tashin zuciya da amai, maƙarƙashiya ko zawo, haɓaka 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 mummunan 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 kara samar da 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.
Tasirin 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.
Ingancin wani abu don rage glucose yana shafar mummunar cutar ta waɗannan magunguna:
- thiazide diuretics;
- hana haifuwa don amfani da baki;
- danazole;
- glucocorticoids;
- kwayoyin 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.
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 tsoma bakin aikin tiyata, waɗanda ba da daɗewa ba sun kamu da kwayar cuta ko cutar, tsofaffi (daga shekaru 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 sani, 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 ku 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 sayen magani na likita.
Kudin maganin sun sha bamban:
- Allunan kwayoyi 1 MG (guda 30 a kowane fakitin) - daga 148 zuwa 167 rubles na Rasha;
- Allunan kwayoyi 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 magunguna babban ƙari ne, gwargwadon ingancinsa. Bugu da kari, amfanin NovoNorm sune:
- sauƙi na amfani da allunan kwatankwacin injections;
- 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 ba su da insulin-insulin sun kwashe NovoNorm na shekaru 5 ko fiye. Sun lura cewa tasirin sa ɗaya ne kuma baya raguwa. Koyaya, sakamakon hypoglycemic na miyagun ƙwayoyi an rage shi zuwa sifili idan KADA KADA:
- bi dacewa da abinci mai kyau (warƙar da takaddun carbohydrates da fats mai sauƙi mai narkewa);
- lura da salon rayuwa mai aiki (yawo aƙalla minti 30, motsa jiki, da sauransu);
- koyaushe kula da matakin glucose (aƙalla sau uku a rana).
Gaba ɗaya, 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.
Magana tana dauke da bangaren aiki guda daya kuma ya bambanta kawai da wasu abubuwan. AllvoNorm Allunan suna da synonym guda ɗaya kawai - Diagniniside (matsakaita na 278 rubles).
Irin waɗannan kwayoyi NovoNorm, waɗanda suka bambanta ga tsarin haɗin gungun, amma suna da sakamako iri ɗaya, sune:
- Jardins (farashin matsakaici - 930 rubles);
- Victoza (matsakaicin farashin - 930 rubles);
- Saksenda (matsakaicin farashin - 930 rubles);
- Forsyga (matsakaicin farashin - 2600 rubles);
- Invokana (matsakaicin farashin - 1630 rubles).
Ana iya ƙarasawa da cewa miyagun ƙwayoyi NovoNorm, wanda ya ƙunshi rayayyun kayan aiki, yana da tasiri a cikin lura da ciwon sukari na 2. Yana sauri rage matakan sukari zuwa matakan al'ada. Idan kun bi tsarin abinci, aikin jiki kuma tare da kulawa akai-akai na tattarawar glucose, zaku iya kawar da hypoglycemia da alamu mai tsanani na ciwon sukari. Bidiyo a cikin wannan labarin zai gaya maka yadda ake bi da ciwon sukari.
