Kwanan nan, wani sabon rukuni na masu magana da cututtukan cututtukan jini wanda ke da tasirin gaske daban daban ya kasance ga masu ciwon sukari a Rasha. Na farko forsig miyagun ƙwayoyi don nau'in ciwon sukari na 2 an yi rajista a cikin ƙasarmu, ya faru ne a cikin 2014. Sakamakon nazarin magungunan yana da ban sha'awa, amfani da shi na iya rage yawan magungunan, kuma a wasu halaye har ma da ware allurar insulin a lokuta mai tsanani na cutar.
Binciken masana ilimin endocrinologists da marasa lafiya sun haɗu. Wani yana farin ciki game da sababbin damar, wasu sun fi son jira har sai an san sakamako na shan miyagun ƙwayoyi na dogon lokaci.
Ta yaya magungunan Forsig ke aiki
Tasirin miyagun ƙwayoyi Forsig ya dogara ne da ikon kodan ya tattara glucose a cikin jini ya cire shi a cikin fitsari. Jiki a cikin jikinmu yana ƙazantar da kullun ta hanyar samfuran metabolism da abubuwa masu guba. Aikin kodan shine tace wadannan abubuwan kuma a kawar dasu. Don wannan, jini yana wucewa ta ƙananan ƙwayoyin koda sau da yawa a rana. A matakin farko, kawai abubuwan gina jiki na jini basa wuce ta cikin matatar, duk sauran ruwan yana shiga cikin glomeruli. Wannan shi ne abin da ake kira fitsari na farko, ana samar da dubun lita a cikin yini.
Ciwon sukari da hauhawar jini zai zama abin da ya wuce
- Normalization na sukari -95%
- Cirewa kan jijiyoyin mara wuya - 70%
- Cire zuciyar mai karfin zuciya -90%
- Rabu da cutar hawan jini - 92%
- Increasearuwar kuzarin rana, inganta bacci da dare -97%
Don zama sakandare kuma shiga cikin mafitsara, ruwan da aka tace dole ne ya zama mai da hankali. Ana samun wannan a mataki na biyu, lokacin da duk abubuwan da suke da amfani - sodium, potassium, da abubuwa na jini - ake karbar su cikin jini a cikin wani nau'in narkar da shi. Jiki kuma yana ɗaukar glucose dole ne, saboda ita ce tushen kuzari ga tsokoki da kwakwalwa. Kayan kwastomomin SGLT2 na musamman masu bada jigilar jini sun mayar dashi jini. Suna samar da wata irin rami a cikin tubule na nephron, wanda sukari ya wuce zuwa jini. A cikin mutum mai lafiya, glucose ya dawo gaba daya, a cikin mara lafiya da ke dauke da ciwon sukari, wani bangare ya shiga cikin fitsari yayin da matakinsa ya zarce bakin mutum na 9-10 mmol / L.
An gano Forsig na miyagun ƙwayoyi godiya ga kamfanonin magunguna waɗanda ke neman abubuwan da zasu iya rufe waɗannan hanyoyin kuma su toshe glucose a cikin fitsari. Bincike ya fara a karni na ƙarshe, kuma a ƙarshe, a cikin 2011, Bristol-Myers Squibb da AstraZeneca sun yi rajista don rajista na sabon magani mai mahimmanci don magance cututtukan sukari.
Abubuwan da ke aiki na Forsigi shine dapagliflozin, shine mai hana garkuwar SGLT2. Wannan yana nuna cewa yana da ikon murƙushe aikinsu. Kasancewar glucose daga fitsari na farko yana raguwa, zai fara fitar da kodan da yawa. Sakamakon haka, matakin jini ya saukar da glucose, babban abokin gaba na tasoshin jini da kuma babban dalilin duk rikice rikice na ciwon sukari. Shahararren fasalin dapagliflozin shine babban zaɓi, yana da kusan babu wani tasiri a cikin masu jigilar glucose zuwa kyallen kuma ba shi da tsangwama ga shafar hanjinsa.
A daidaitaccen sashi na miyagun ƙwayoyi, kusan 80 g na glucose ana fito dashi a cikin fitsari kowace rana, ƙari, komai yawan insulin da ƙwayar ƙwayar ƙwayar cuta ta samar, ko a matsayin allura. Ba ya tasiri da ingancin Forsigi da kasancewar insulin juriya. Haka kuma, raguwa a cikin tarawar glucose yana sauƙaƙa hanyar ɗaukar ragowar sukari ta cikin membranes cell.
A cikin wane yanayi aka sanya
Forsyga ba zai iya cire duk yawan sukari ba yayin cin abinci na carbohydrates daga abinci. Amma ga sauran wakilai masu yawan zubar da jini, abinci da kuma aiki na jiki yayin amfani da su shine akeyin kamfani. A wasu halaye, monotherapy tare da wannan magani yana yiwuwa, amma mafi yawan endocrinologists suna ba da forsig tare da Metformin.
Alƙawarin da miyagun ƙwayoyi a cikin wadannan halaye bada shawarar:
- don sauƙaƙa asarar nauyi a cikin marasa lafiya da masu ciwon sukari na 2;
- azaman ƙarin kayan aiki idan akwai wani rashin lafiya mai wahala;
- don gyaran kurakurai na yau da kullun a cikin abincin;
- a gaban cututtukan da ke kawo cikas ga aikin mutum.
Don lura da ciwon sukari na 1, ba a yarda da wannan magani ba, tun da yawan adadin glucose da aka yi amfani da shi tare da taimakon sa ya canza kuma ya dogara da dalilai da yawa. Ba shi yiwuwa a lissafta adadin insulin ɗin da ake buƙata a cikin irin wannan yanayin, wanda ke cike da cututtukan hypo- da hyperglycemia.
Duk da babban inganci da sake dubawa mai kyau, Forsiga bai riga ya karbi rarrabuwa ba tukuna. Akwai dalilai da yawa don wannan:
- babban farashinsa;
- karancin lokacin karatu;
- bayyanuwa kawai ga alamomin cutar sankarau, ba tare da anfaninta sanadin hakan ba;
- sakamako masu illa.
Umarnin don amfani da miyagun ƙwayoyi
Forsig yana samuwa a cikin nau'i na Allunan 5 da 10 MG. Thewarin da aka ba da shawarar yau da kullun a cikin in babu contraindications akai-akai - 10 MG. An zaɓi kashi na metformin daban-daban. Lokacin da aka gano cutar sankara, Forsigu 10 MG da 500 MG na metformin galibi ana wajabta su, bayan wannan ana daidaita sashi na karshen gwargwadon abubuwan da ke nuna alamar glucose.
Aikin kwaya ya ɗauki awanni 24, don haka ana shan maganin kawai sau 1 a rana. Cikakken kamshi na Forsigi bai dogara da ko maganin ya bugu a ciki ba ko abinci. Babban abu shine a sha shi da isasshen adadin ruwa kuma a tabbatar da daidaituwa tazara tsakanin allurai.
Magungunan yana shafar yawan fitsari a kullun, don cire 80 g na glucose, kimanin 375 ml na ruwa ana buƙatar ƙari. Wannan shine kusan tafiyar ƙarin bayan gida a rana. Dole ne a sauya ruwan da ya ɓace don hana ruwa bushewa. Saboda kawar da wani ɓangare na glucose lokacin shan magani, ana rage yawan adadin kuzari na abinci da kusan adadin kuzari 300 a rana.
Sakamakon sakamako na miyagun ƙwayoyi
Lokacin rajistar Forsigi a Amurka da Turai, masana'anta sun sami matsaloli, hukumar ba ta amince da maganin ba saboda fargabar cewa hakan na iya haifar da ciwace-ciwacen kumburi. A lokacin gwaji na asibiti, an ƙi waɗannan zato, ba a bayyana kaddarorin dabbobi ba a cikin Forsigi.
Zuwa yau, akwai bayanai daga nazari sama da dozin da suka tabbatar da amincin lafiyar wannan magani da kuma ikonta na rage sukarin jini. Lissafin illolin sakamako da yawan abubuwan da suke faruwa an kafa su. Duk bayanan da aka tattara ya danganta ne da ɗan gajeren lokacin magunguna Forsig - kimanin watanni shida.
Babu bayanai game da sakamakon ci gaba da amfani da magani na dogon lokaci. Masana ilimin halitta sun bayyana damuwa cewa yin amfani da miyagun ƙwayoyi na tsawan lokaci na iya shafar aikin kodan. Sakamakon cewa an tilasta su suyi aiki tare da yawan zubar da ruwa akai-akai, ƙimar fil ɗin glomerular na iya raguwa kuma yawan fitowar fitsari na iya raguwa.
An gano illolin da ke tattare da illar har yanzu:
- Lokacin da aka tsara shi azaman ƙarin kayan aiki, raguwa mai yawa a cikin sukari na jini yana yiwuwa. Abun lura da yawan jini shine yawanci mai laushi.
- Cutar kumburin ƙwayar ƙwayar cuta ta hanyar kamuwa da cuta.
- Anaruwar yawan fitsari ya wuce adadin da ake buƙata don cire glucose.
- Levelsara matakan lipids da haemoglobin a cikin jini.
- Haɓaka ƙwaƙwalwar jini na jini wanda ke da alaƙa da aiki na keɓaɓɓen aiki a cikin marasa lafiya waɗanda suka girmi shekaru 65.
A cikin ƙasa da 1% na marasa lafiya da ciwon sukari, magunguna suna haifar da ƙishirwa, raguwar matsin lamba, maƙarƙashiya, yawan cin gumi, yawan motsa jiki na dare.
Babban faɗakarwar likitocin shine ya haifar da ci gaban cututtukan cututtukan ƙwayoyin cuta saboda amfanin Forsigi. Wannan sakamako na gefen yana da kusan gama gari - a cikin 4.8% na marasa lafiya da ciwon sukari. 6.9% na mata suna da ƙwayar cuta ta asali da ƙwayar cuta. An yi bayanin wannan ta hanyar gaskiyar cewa karuwar sukari yana haifar da haɓaka ƙwayoyin ƙwayoyin cuta a cikin fitsari, fitsari da farji. A cikin kariya ga miyagun ƙwayoyi, ana iya faɗi cewa waɗannan cututtukan cututtukan sune galibi masu saukin kai ne ko matsakaici kuma suna da kyau ga ingantaccen farjin. Mafi yawan lokuta suna faruwa ne a farkon farawar Forsigi, kuma da wuya a maimaita su bayan magani.
Umarnin don amfani da miyagun ƙwayoyi yana fuskantar canje-canje a koyaushehade da gano sabbin sakamako masu illa da hana daukar ciki. Misali, a cikin watan Fabrairun 2017, an ba da gargaɗi cewa yin amfani da inhibitors SGLT2 yana ƙara haɗarin yatsun yatsun hannu ko ɓangaren ƙafa sau 2. Bayanin da aka sabunta zai bayyana a cikin umarnin magungunan bayan sababbin karatun.
Abubuwan Taimakawa
Contraindications don shigowa sune:
- Nau'in sukari na 1 na ciwon sukari, tunda ba a hana yiwuwar kamuwa da cutar rashin ƙarfi ba.
- Lokacin daukar ciki da lactation, shekaru har zuwa shekaru 18. Ba a samu tabbacin lafiyar miyagun ƙwayoyi ga mata masu juna biyu da ƙananan yara ba, da kuma yiwuwar shigar da ita cikin madara nono.
- Shekaru sama da 75 a sanadiyar raguwar ilimin halittar jiki a cikin aikin koda da kuma raguwa a cikin bugun jini.
- Rashin haɗarin Lactose, shi azaman babban taimako ɓangare ne na kwamfutar hannu.
- Allergy zuwa dyes amfani da allunan harsashi.
- Concentara yawan taro a cikin jinin ketone jikin.
- Ciwon sukari mai narkewa tare da raguwa a cikin yawan tacewar duniya zuwa 60 ml / min ko gawurtaccen kididdigar da ba ta da alaƙa da ciwon sukari mellitus.
- Amincewa da madauki (furosemide, torasemide) da thiazide (dichlothiazide, polythiazide) saboda karuwar tasirin su, wanda ya cika tare da raguwa da matsin lamba da rashin ruwa.
An yarda da karɓa, amma ana buƙatar taka tsantsan da ƙarin kulawa na likita: tsofaffi marasa lafiya da ke fama da ciwon sukari, mutanen da ke fama da hepatic, bugun zuciya ko gazawar renal rauni, cututtuka na kullum.
Ba a gudanar da gwaje-gwaje na sakamakon barasa ba, nicotine da samfuran abinci iri-iri akan tasirin maganin.
Shin yana iya taimakawa rasa nauyi
A cikin bayani game da miyagun ƙwayoyi, masana'antun Forsigi suna ba da labari game da raguwar nauyin jiki wanda aka lura yayin gudanarwa. Wannan sananne ne musamman a cikin marasa lafiya da ciwon sukari mellitus tare da kiba. Dapagliflozin yana aiki azaman diuretic mai sauƙi, yana rage yawan ƙwayar ruwa a cikin jiki. Tare da nauyi mai yawa da kuma gaban edema, wannan shine aƙasa kilogiram 3-5 na ruwa a cikin makon farko. Za'a iya samun irin wannan sakamako ta hanyar sauya zuwa tsarin cin abinci mara gishiri sannan kuma a taƙaice rage yawan abinci - jiki nan da nan zai fara kawar da danshi mara amfani.
Dalili na biyu don asarar nauyi shine raguwar adadin kuzari saboda cire wani ɓangaren glucose. Idan an saki 80 g na glucose a cikin fitsari a kowace rana, wannan yana nufin asarar adadin kuzari 320. Don rasa kilogram na nauyi saboda kitse, kuna buƙatar kawar da adadin kuzari 7716, wato rasa 1 kg zai ɗauki kwanaki 24. A bayyane yake cewa Forsig zaiyi aiki ne kawai idan akwai ƙarancin abinci mai gina jiki. Don kwanciyar hankali, asarar nauyi dole ne ya bi abincin da aka tsara kuma kar a manta game da horo.
Mutane masu lafiya bai kamata su yi amfani da Forsigu don asarar nauyi ba. Wannan magani ya fi aiki tare da matakan glucose na jini. Kusa da ita ya zama na al'ada, da saurin tasirin maganin. Kar ku manta game da matsananciyar damuwa ga kodan da ƙarancin kwarewa tare da amfani da miyagun ƙwayoyi.
Forsyga yana samuwa ne kawai ta takardar saiti kuma an yi shi ne kawai don marasa lafiya da ke fama da ciwon sukari na 2.
Neman Masu haƙuri
Masana ilimin kimiyar halittun endocrinologist ya ayyana kawai Forsig da abinci a gare ni, amma tare da yanayin cewa zan bi dokokina sosai kuma halartar liyafar kai tsaye. Glucose a cikin jini ya ragu sosai, har zuwa kusan kwana 7 a cikin 10. Yanzu ya kasance watanni shida da suka gabata, ba a ba ni sauran magunguna ba, Ina jin lafiya, na rasa kilo 10 a wannan lokacin. Yanzu a tsaka-tsakin hanya: Ina so in yi hutu a cikin magani don ganin idan zan iya ci gaba da sukari da kaina, a kan abincin ne kawai, amma likita bai yarda ba.
Menene analogues
Magungunan Forsig shine kawai magani a cikin ƙasarmu tare da dapagliflosin mai aiki. Ba a samar da cikakken analogues na ainihin forsigi ba. A matsayin madadin abu, zaku iya amfani da kowane irin kwayoyi daga aji na glyphosines, aikin wanda ya dogara da hanawar masu jigilar SGLT2. Irin waɗannan magunguna guda biyu sun wuce rajista a Rasha - Jardins da Invokana.
| Suna | Abu mai aiki | Mai masana'anta | Sashi | ~ Kudin (watan shigarwar) |
| Forsyga | dapagliflozin | Kamfanoni Bristol Myers Squibb, Amurka AstraZeneca UK Ltd, UK | 5 MG, 10 MG | 2560 rub. |
| Jardins | empagliflozin | Beringer Ingelheim International, Jamus | 10 MG, 25 MG | 2850 rub. |
| Invokana | canagliflozin | Johnson & Johnson, Amurka | 100 MG, 300 MG | 2700 rub. |
Kimanin farashin kusan Forsigu
Wata daya da shan magungunan Forsig zai biya kusan dala dubu 2 da dubu rubles. Don sanya shi a hankali, ba mai rahusa ba, musamman idan kunyi la'akari da wakilai masu buƙatar hypoglycemic, bitamin, abubuwan cin abinci na glucose, da maye gurbin sukari, waɗanda suke da mahimmanci ga ciwon sukari. Nan gaba kadan, halin da ake ciki ba zai canza ba, tunda maganin sabo ne, kuma mai masana'anta na neman dawo da kudaden da aka kashe a ci gaba da bincike.
Za'a iya tsammanin ragin farashin ne kawai bayan sakin kwayoyin halittu - kudade tare da irin wannan haɗin na sauran masana'antun. Analolera masu araha zasu bayyana ba a farkon 2023 ba, lokacin da ikon mallaka na Forsigi ya ƙare, kuma mai ƙirar samfurin asalin ya rasa haƙƙin keɓantaccen shi.
