Hukumar Kiwon Lafiya ta Duniya ta kira batun matsalar kiba da aka yiwa karni na 21. A cikin mutane biliyan 7 a duniya, miliyan 1,700 ne masu kiba da miliyan 500 masu kiba. Dangane da hasashen da aka yiwa masu takaici, nan da shekarar 2025 yawan mutane masu kiba zasu wuce biliyan 1! A Rasha, 46.5% na maza da 51% na mata suna da kiba sosai, kuma waɗannan alƙalum suna ƙaruwa koyaushe.
Dangane da manufofin likita, kiba yana ɗaukar nauyin jiki fiye da 30% ko fiye. Girman nauyi saboda kitse, galibi a cikin ciki da cinya.
Baya ga rashin damuwa ta jiki da ta kwakwalwa, babbar matsalar kiba ita ce rikice-rikice: da yiwuwar haɓakar cututtukan zuciya, cututtukan tsarin tsoka, hauhawar jijiyoyin jini, atherosclerosis, da kuma nau'in ciwon sukari na 2 yana ƙaruwa.
Normalizing nauyi a cikin irin wannan yanayi kawai tare da taimakon dacewa da kayan abinci mai salo ba zai yiwu ga kowa ba, da yawa suna neman taimakon magunguna. Ka'idojin bayyanar irin wadannan kwayoyi sun banbanta: wasu na rage ci, wasu na toshe shaye-shayen fitsari da mai, wasu kuma suna da tasirin maye wanda baya barin abinci yaci abinci sosai.
Daga cikin waɗannan magunguna masu ƙarfi akwai Sibutramine (a cikin takardar maganin Latin - Sibutramine).
Magungunan rashin lafiyar, wanda ya ƙaru a ƙarshen karni na ƙarshe da kamfanin na Amurka Abbott Laboratories, bai aiwatar da tsammanin sa ba, amma ya tabbatar da cewa yana da ƙarfi mai ƙarfi. Rashin nauyi yana da mahimmanci sosai har ya fara nada marasa lafiya da ƙoshin kiba, ba tare da kulawa da sha'awar su ba.
Dalilin da yasa aka haramta Sibutramine
Tsakanin yan koyo, duk matsalolin da zasu magance ta hanyar kwayar banmamaki, maganin ya samu karbuwa sosai a duk duniya. Magunguna wanda ke tayar da jijiyoyin jiki kuma yana hana ci abinci mara wahala, WHO tayi annabci game da rayuwa mai zuwa.
Bugu da ƙari, Sibutramine ya haifar da dogaro mai dangantaka da miyagun ƙwayoyi (sakamakon ecstasy ko amphetamine). Musamman majinyacin da suka manyanta suna da wahalar jure wa jiyya. Kafin ƙarin binciken, an dakatar da miyagun ƙwayoyi a Amurka, Kanada, Australia, Turai, Ukraine. A cikin cibiyar sadarwar magunguna ta gida, za'a iya siye shi tare da takardar sayan magani.
An wajabta Anorectic don ƙarancin kiba na digiri na II-III, lokacin da BMI ya wuce 30-35 kg / m 2 kuma sauran hanyoyin magani ba su da tasiri. Tsarin kulawa na warkewa ya haɗa da abinci na musamman, kazalika da isasshen aikin jiki.
An nada shi ga dukkanin masu haɗin tare da ba tare da shi ba. Amma ba da daɗewa ba likitocin sun fara yin kararrawa saboda tasirin sakamako: marasa lafiya suna da rikice-rikice na kwakwalwa, haɓaka haɗarin bugun zuciya, ƙara yawan kashe kansu.
Hakanan ana nuna magungunan don nau'in ciwon sukari na 2 na sukari, hyper- da hyperproteinemia. A cikin waɗannan halayen, ƙididdigar taro na jiki ya kamata ya fi 27kg / m². Treatmentarancin kulawa, gami da Sibutramine da kuma analogues, ana aiwatar da su a karkashin kulawa ta likita.
Wani mahimmin bangare na hanya shine motsawar mai haƙuri don canza salon rayuwa da abinci yayin riƙe sakamako sakamakon magani. Me yasa aka hana Sibutramine a cikin ƙasashe masu wayewa, kalli bidiyon a cikin rahoton TV:
Pharmacodynamics anorectic
A cikin kai, nau'ikan kwakwalwa daban-daban suna da alhakin jin daɗin satiety. Haɗin tsakanin su yana faruwa ne saboda ayyukan neurons, wanda hakan ke haifar da ci, yana roƙon mu zuwa wani abun ciye-ciye.
Lokacin da abinci ya shiga ciki, abubuwan jijiya suna fallasa tsarin kwakwalwar da ke da alhakin jin dadi. Amma jin yunwar ba lallai bane yana da tushen ilimin lissafi: wani lokacin kuna so ku sami cizo don rage tashin hankali, shakatawa, kuma ku ji daɗin aiwatarwa.
Sibutramine ya dace da tsarin duka, yana aiki akan neurons. An haɗa sel ta amfani da synapses - mahadi waɗanda ke jagorantar siginar azaman lambobin sadarwa a cikin wayoyin. Duk wani aiki na mai neuron yana tare dashi tare da sakawa cikin neurotransmitter - wani kwayar halitta mai aiki da kayan halitta wanda ya haɗu tare da masu karɓar ragowar neurons. Don haka sigina na wuce sarkar su. Bayani kan yunwar ko satiety ana kuma yada shi ta wannan hanyar.
Daidaitawa na taimakawa wajen sarrafa serotonin: idan girmanta ya ragu, mutum yana fuskantar yunwar. A kan aiwatar da cin abinci, ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa yana haɗuwa, lokacin da adadinta ya kai wani iyaka, jiki yana jin daɗin jijiyar jiki.
Magungunan yana tsawanta wannan ji ta hanyar kiyaye matakan da suka dace na serotonin a cikin synoptic. Godiya ga wannan sakamako, mai haƙuri yana haɓaka halayen cin abinci masu lafiya, hare-hare na dare da dare yana ƙare, kuma yawan abincin da aka ƙone yana raguwa.
Anorectic yana hana sake farfado da norepinephrine, wanda aka samar a cikin tsarin juyayi na tsakiya, inda yake taka rawa iri ɗaya kamar mai maganin ƙwaƙwalwar ƙwaƙwalwa. Increasearuwar abun cikin ta a cikin rarar synoptiki yana haifar da karuwar kuzari. Ofaya daga cikin sifofin wannan kayan shine kunnawa na thermogenesis, wanda ke fitar da makamashi daga hanta, adipose da ƙashin tsoka. Wannan yana taimakawa rage kitse na jiki da kuma daidaita dabi'ar metabolism.
A ƙarƙashin rinjayar mai sarrafa roba na Sibutraminum mai ci, canje-canjen halayen abinci, thermogenesis yana ƙaruwa. Masu kitsen mai sun ƙone, kuma yawan adadin kuzari baya ba da damar a mayar dasu. Therarancin thermogenesis yana kunna b-adrenergic masu karɓa waɗanda ke sarrafa samar da makamashi. Rage yawan ci yana da alaƙa da hanawa na sake farfado da norepinephrine da serotonin.
Magana game da sashi, sakamako masu illa sau da yawa suna nuna ƙananan raguwa a cikin karfin jini da tachycardia. Kuna iya ganin damar Sibutramine da tsarin aikinta akan bidiyon:
Pharmacokinetics na Sibutramine
Har zuwa 80% na maganin baka yana saurin narkewa a cikin narkewa. A cikin hanta, an canza shi zuwa metabolites - monodemethyl- da didemethylsibutramine. Babban abu mafi girma shine babban abu mai karfi wanda aka rubuta bayan mintuna 72 daga lokacin amfani da kwamfutar hannu mai nauyin 0.015 g, metabolites yana mai da hankali akan sa'o'i 4 masu zuwa.
Idan kun ɗauki kwalliyar yayin cin abinci, tasirinsa ya ragu da na uku, kuma lokacin da za a kai ga ƙarshen sakamako yana ƙaruwa 3 hours (jimlar matakin da rarraba ba su canzawa). Har zuwa 90% na sibutramine da metabolites suna ɗaure zuwa serum albumin kuma ana rarraba su da sauri a cikin ƙwayar tsoka.
Abun da ke cikin abubuwan da ke aiki a cikin jini ya kai matsayin daidaitawa bayan sa'o'i 96 daga lokacin amfani da kwamfutar hannu ta farko kuma ya ninka sau 2 fiye da maida hankali bayan kashi na farko na maganin.
Sibutramine yayin daukar ciki
An yi nazarin maganin a cikin dabbobi masu juna biyu. Magungunan ba su shafi ikon yin juna biyu ba, amma a cikin zomo gwaje-gwaje akwai tasirin teratogenic na maganin a tayin. An lura da abubuwan ban mamaki a canje-canje a cikin bayyanar da tsarin kasusuwan.
Dukkanin analogues na Sibutramine an soke su har ma a matakin shirin daukar ciki. Tare da shayar da nono, maganin kuma yana contraindicated.
Duk tsawon lokacin kulawa da Sibutramine da kwanaki 45 bayan hakan, matan da suka isa haihuwa za su yi amfani da tabbatattun maganin hana haihuwa. Kafin yanke shawara don asarar nauyi tare da miyagun ƙwayoyi, ya kamata kuyi tunani game da shirin ciki na gaba.
Magungunan yana da teratogenic, kuma kodayake ba a kafa ikonsa na tsokanar maye gurbi ba, kwayar ba ta da tushe ta tabbataccen tushe, kuma za a kara jerin abubuwan contraindications.
Jerin maganin hana daukar ciki na Sibutramine
Don anorectics, akwai, da farko, tsarin tsarin shekaru: ba a ba da magani ga yara da manya (bayan shekaru 65). Akwai sauran contraindications for Sibutramine:
Kiba ta sakandare, tsokani ta hanyar cututtukan endocrine da tsarin juyayi na tsakiya, da sauran ka'idodi na dabi'ar halitta;- Rashin rikice-rikice - daga anorexia zuwa bulimiya (duka a gaban da kuma a cikin anamnesis);
rikicewar kwakwalwa; - Rashin daidaituwa na gudanawar ƙwayar cuta ta mahaifa (data kasance ko a cikin tarihi);
- Goiter na dabi'a mai guba;
- Pheochromocytoma;
- IHD, canje-canje a cikin ƙwayar zuciya na ƙwayar zuciya da dysfunction ta na yau da kullun a cikin matakin lalata;
- Glucose-galactose malabsorption, hypolactasia;
- Warfin zubar da jini ga jijiyoyin waje;
- Raguwar da ba a sarrafawa ba cikin hauhawar jini daga 145 mm Hg. Art. kuma sama;
- Mai tsananin hanta da koda;
- Adenoma Prostate tare da urination mai rauni;
- Almubazzaranci da giya;
- Clou-angle glaucoma;
- Sanarwa da kowane daga cikin abubuwan da ke cikin tsari.
Kiba ta sakandare, tsokani ta hanyar cututtukan endocrine da tsarin juyayi na tsakiya, da sauran ka'idodi na dabi'ar halitta;
Musamman kulawa a cikin alƙawarin Sibutramine ya kamata a ba wa marasa lafiya masu hauhawar jini, marasa lafiya da raunin hawan jini, koke-koke na rashi, tarihin rashin ƙarfi, amai, hanta ko ƙoshin koda, glaucoma, cholecystitis, basur, basir, da kuma marasa lafiya da ke shan magungunan da ke shafar cutar. jini coagulability.
Sakamakon mara amfani
Sibutramine magani ne mai mahimmanci, kuma kamar kowane magani mai mahimmanci da sakamako masu illa, ba haɗari ba ne cewa a cikin ƙasashe da yawa magungunan hukuma sun haramta. Mafi sauki shine halayen rashin lafiyan mutum. Ba girgiza cutar anaphylactic, ba shakka, amma rashes na fata yana yiwuwa. Fitsari da kanshi na faruwa lokacin da aka daina maganin ko kuma bayan an daidaita shi.
Morearin lahanin sakamako mai illa shine jaraba. Ruwan sha mai 1-2 shekaru, amma mutane da yawa ba su iya dakatarwa, ƙarfafa dogara da miyagun ƙwayoyi, kwatankwacin shan kwayoyi. Yaya jikin ku zai kasance mai kulawa da Sibutramine, ba shi yiwuwa a tantance a gaba.
Sakamakon dogaro ana iya ganinta a farkon watan 3 na amfani na yau da kullun.
Yarinya ya zama mai sauƙi. Yanayin da ya yi kama da "watsewa" shine migraine, daidaitawa mara kyau, barcin mara kyau, damuwa na yau da kullun, damuwa mai ƙarfi, canzawa da rashin tunani da tunani na kashe kansa.
Magungunan ta sa baki tare da aikin "tsarkakakken abubuwan tsarkakewa" - kwakwalwar mutum da tsarin juyayi. Ba koyaushe zai yiwu a shafi kwakwalwa da tsarin juyayi na tsakiya ba tare da sakamako ga psyche ba. Yunkurin farko a magani ya ƙare tare da dogaro mai ƙarfi, kashe kansa, raunin kwakwalwa, mutuwa daga bugun zuciya da kwakwalwa.
Wani magani na zamani yana ɗaukar tsabtatawa mai inganci, ana rage raguwa sosai, amma ba a cire tasirin da ba a tsammani ba. Game da sa hannu a cikin zirga-zirga da kuma gudanar da abubuwa masu rikitarwa, yin aiki mai tsayi, a kowane sauran yanayi wanda ke buƙatar saurin amsawa da karuwa da kulawa, ba a yarda yayin jiyya tare da Sibutramine ba.
A Sibutramine, umarnin don amfani ya tabbatar da cewa mafi yawan alamomin (tachycardia, hyperemia, hauhawar jini, rashin ci, canje-canje a dandano, damuwa a cikin rudani na rashin nasara, basur, cututtukan dyspeptik, sweating, damuwa, da rashin damuwa) sun ɓace bayan cirewar magani.
Nazarin Sibutramine a Turai - ra'ayin masana
Nazarin LITTAFIN, wanda hukumomi na EU suka shafa suka fara bayan nazarin ƙididdigar likita na baƙin ciki, masu hannu da shuni tare da yawan adadin ƙwayoyin jikin mutum da haɗarin haɓaka cututtukan zuciya.
Sauran halayen masu haɗari sun haɗa da halayen rashin lafiyan yanayin bambance bambancen yanayi, lalacewar tsarin jini (raguwa cikin ƙididdigar platelet), lalacewar kai ga bangon jijiyoyin jiki, da raunin hankali.
Tsarin juyayi ya ba da amsa a cikin nau'i na kashin tsoka, gazawar ƙwaƙwalwar ajiya. Wasu mahalarta suna da raɗaɗi a cikin kunnuwansu, baya, kai, da hangen nesa da ji. An kuma lura da rikice-rikice na ciki. A ƙarshen rahoton, an lura cewa ciwon sikila na iya haifar da ciwon kai da ciwan mara amfani.
Kara karantawa game da yadda Sibutramine ke ƙona kitse kuma yana inganta yanayi - a cikin bidiyo
Yadda ake amfani da anorectics
Ana ɗaukar kwamfutar hannu sau ɗaya. Rashin abinci ba ya shafar sakamakon. A farkon hanya, ana bada shawara a sha cokali ɗaya wanda ke nauyin 0.01 g .. An haɗiye shi gaba ɗaya an shayar da shi da ruwa.
Idan a farkon wata nauyin ya wuce cikin 2 kilogiram kuma an yarda da magani na yau da kullun, zaku iya ƙara adadin zuwa 0, 015 g. Idan a cikin wata mai zuwa ƙididdigar nauyin ta kasa da kilogiram 2, an soke maganin, tunda yana da haɗari don daidaita sashi gaba.
Rushe hanyar jiyya a lamuran masu zuwa:
- Idan kasa da 5% na farkon taro ya ɓace a cikin watanni 3;
- Idan aiwatar da asarar nauyi ya tsaya a alamomi har zuwa 5% na taro na farko;
- Mai haƙuri ya fara samun nauyi sake (bayan rasa nauyi).
Yi amfani da miyagun ƙwayoyi ba da shawarar ba fiye da shekaru 2.
Don ƙarin bayani game da Sibutramine, duba horarwar bidiyo akan bidiyo:
Yawan damuwa
Rashin bin shawarwari, kara allurai yana kara hadarin yawan zubar jini. Ba a yi nazarin sakamakon irin waɗannan sakamakon ba, don haka ba a ci gaba da maganin ba. A matsayin ɓangare na kulawa ta gaggawa don irin waɗannan bayyanar cututtuka, ana wanke ciki ga wanda aka azabtar, ana ba su magungunan enterosorbents idan ba su wuce awa ɗaya ba bayan shan Sibutramine.
Lura da canje-canje a cikin yanayin wanda aka azabtar yayin rana. Idan alamun bayyanar cututtuka suna bayyana, ana yin maganin cututtukan alamu. Mafi yawan lokuta, ana lura da hawan jini da hauhawar zuciya. Irin waɗannan alamun suna tsayawa tare da β-blockers.
Zaɓuɓɓuka don hulɗa na Sibutramine tare da wasu magunguna
Ba da shawarar yin amfani da anorectic ba:
- Tare da magunguna don magance cututtukan kwakwalwa ko kiba mai yawa, waɗanda ke da tasirin gaske;
Tare da magungunan da ke toshe yiwuwar monoamine oxidase (tsakanin yin amfani da Sibutramine da kuma amfani da masu hanawa, dole ne a kiyaye tazara aƙalla kwanaki 14);- Tare da kwayoyi waɗanda ke haɓaka haɓakar serotonin da hana haɓaka reuptake;
- Tare da kwayoyi waɗanda ke hana microsomal hepatic enzymes;
- Tare da magunguna waɗanda ke tsokani tachycardia, saukad da jini, haɓaka tsarin juyayi mai juyayi.
Tare da magungunan da ke toshe yiwuwar monoamine oxidase (tsakanin yin amfani da Sibutramine da kuma amfani da masu hanawa, dole ne a kiyaye tazara aƙalla kwanaki 14);Sibutramine bai dace da barasa ba. Allunan waɗanda suka danganci abin da ke faruwa game da abinci ba sa canza magungunan ƙwayoyin hana ƙwayoyin cuta.
Sharuɗɗan siye da ajiya
Duk da cewa a cikin ƙasashe da yawa an haramta Sibutramin a cikin cibiyar sadarwa ta hukuma, Intanet tana cike da irin wannan tayin. Don haka zaka iya siyan anorectics ba tare da takardar sayan magani ba. Gaskiya ne, ƙarshen sakamakon wannan halin dole ne a kula da shi da kaina. Don Sibutramin, farashin (kusan 2 dubu rubles) shima ba kowa bane.
Dokokin adana magunguna sune daidaitattun: zafin jiki na ɗakin (har zuwa 25 ° C), ikon rayuwar rayuwa (har zuwa shekaru 3, bisa ga umarnin) da kuma damar yara. Allunan an fi dacewa a cikin fakitin asali.
Sibutramine - analogues
Babban tushe mai shaida (amma ba mafi ƙarancin kuɗi ba) yana da Xenical - magani ne mai kama da tasirin magani, wanda aka yi amfani da shi a cikin kiba. A cikin hanyar sadarwar ciniki akwai maganar Orlistat. Abubuwan da ke aiki suna toshe kitsen mai daga bangon hanji da cire su da dabi'a. Cikakken sakamako (20% mafi girma) yana bayyana ne kawai lokacin cin abinci.
Bambance-bambance tsakanin Sibutramine da Xenical suna cikin yuwuwar likitanci: idan tsohon ya rage ci abinci ta hanyar aiki a kwakwalwar da cibiyoyin jijiyoyi, ɗayan yana cire kitsen, yana ɗaure su da tilasta jiki don kashe ɗanyen kitsensa don rama farashin kuzarin. Ta hanyar tsarin juyayi na tsakiya, Sibutramine yana aiki akan dukkan gabobin tsarin, Xenical baya shiga cikin tsarin jijiyoyin jini, kuma baya tasiri ga gabobi da tsarin.
Fenfluramine shine anarotonergic analogue daga rukuni na abubuwan samo asali na amphetamine. Yana da tsarin aiwatarwa kamar Sibutramine kuma an haramta shi a kasuwa azaman kayan maye.
Fluoxetine, maganin hana daukar ciki wanda ke hana maye gurbin serotonin, shima yana da yiwuwar anorectic.
Ana iya inganta jerin abubuwan, amma duk magunguna na anorexigenic, kamar na asali, suna da tasirin sakamako masu yawa kuma suna iya cutar lafiyar sosai. Asalin ba shi da alamun analogues mai cike da cikakken iko, masu kula da sha'awar masana'antar Indiya sun fi yawa ko ƙarancin sani - Slimia, Gold Line, Redus. Babu buƙatar yin magana game da kayan abinci na kasar Sin - cat 100% a cikin jaka.
Lightxin Haske - ƙari ne na abinci wanda ya danganta da oxygentriptan, wanda ba shi da alaƙa da sibutramine, yana da ƙwaƙwalwar magani, kuma yana hana ci. Shin akwai alamun analogues mai rahusa ga Sibutramine? Akwai Listata da Gold Line Haske na kayan abinci suna da tsari daban-daban, amma tsarin shirya kayan kwalliya sun yi kama da na Sibutramine na asali. Irin wannan dabarar tallan tallace-tallace shakka ba ta shafar ingancin mai ƙari.
Ra'ayoyin rasa nauyi da likitoci
Wasu sake dubawa suna damu game da Sibutramine, wadanda abin ya shafa da danginsu suna firgita da sakamakon sakamako masu illa, suna roƙon su daina jiyya. Amma waɗanda suka tsira daga lokacin karbuwa kuma ba su bar hanya ba, an lura da ci gaba mai kyau.
Game da Sibutramine, sake dubawar likitocin sun kasance mafi hanawa: likitoci ba su musun babban tasiri na Sibutramine ba, suna tunatar da ku da cikakkiyar dacewa ga takardar sayan magani da saka idanu na yau da kullun game da rasa nauyi. Sun yi gargaɗi game da haɗarin shan magungunan kai, tunda magungunan suna da matuƙar nauyi kuma babu wanda zai aminta daga sakamako masu illa.
A cewar kididdigar, a kalla ɗayan abubuwan da ba a ke so ba suna fuskantar 50% na waɗanda suka rasa nauyi tare da Sibutramine. Ba daidaituwa ba ne cewa an haramta amfani da miyagun ƙwayoyi a cikin yawancin ƙasashe masu tasowa na tattalin arziki, kuma Rasha na kunshe cikin jerin magunguna masu ƙarfi.
Tattaunawa da ƙwararrun masani kan amfani da Sibutramine da gyaran kai na yanayin motsin rai - a cikin bidiyon:
