ʻO Repaglinide - kahi hui o nā lāʻau lapaʻau, nā ʻōlelo aʻo a pehea e loli ai

Ua hoʻokaʻawale ʻia nā lāʻau lapaʻau e hoʻoikaika ai i ka hana o ka insulin i nā pūʻulu 2: ka pālahalaha sulfonylurea ākea a me nā meglitinides kaulana i ʻike ʻia, a i ʻole nā ​​glinids. He lālā ʻo Repaglinide kahi lua o ka hui ʻelua. ʻO ka hopena o ke kōlooha hoʻoilo i ka waiwai e hoʻohālikelike ʻia me ka hoʻomākaukau ʻana o ka sulfonylurea.

Hoʻonui ʻo Repaglinide i ka synthesis o ke kō o ka insulin, ʻaʻohe o ka pae o ka glucose i loko o nā moku, no laila hiki pū iā ia ke alakaʻi i ka hypoglycemia. ʻO ka ʻokoʻa ma waena o kēia lāʻau lapaʻau ke hoʻomaka koke a me ka manawa pōkole o ka hana, e hiki ai iā ʻoe ke hoʻemi pono i ka glycemia, hoʻomaʻamaʻa ʻole me ka pili ʻana i ka momona a me ke kaumaha. ʻO ka kaulana o ka lāʻau e hoʻopau i ka pono no ka lawe ʻana ma mua o kēlā me kēia pāʻina, kahi e hoʻonui ai i ka hoʻēmi ʻana i nā palaho a me ka hoʻēmi ʻana i ka pili ʻana o nā maʻi maʻi i ka mālama i kuhikuhi ʻia.

Hoʻomākaukau ʻaʻa repaglinide

ʻO Repaglinide kahi inoa honua e ʻike ʻia ai ka lāʻau lapaʻau ma nā wahi āpau o ka honua. Ma ke ʻano he mea hoʻoikaika nui, ʻo ka repaglinide kahi hapa o nā papa i hana ʻia e nā ʻano lāʻau lapaʻau like ʻole ma lalo o kā lākou mau kāleka. Aia ka inoa inoa kālepa no ka repaglinide i loko o ka papa inoa o ka lāʻau Lūkini:

ʻO ka lāʻau kanu kumu no ka Danish NovoNorm. Ua hoʻokau ʻia nā hōʻike koʻikoʻi āpau me ke komo ʻana o kēia lāʻau lapaʻau kūikawā. Loaʻa ka NovoNorm i nā waihona waiwai o ka 0.5; 1 a me 2 mg, ma kahi pākahi o 30 mau papa. He haʻahaʻa ke kumu o kahi ʻeke - mai 157 a 220 mau rubles. no kahi ʻāpana ʻokoʻa.

ʻO Diagninid lāua ʻo Iglinid he mau generics, a i nā analogue, na NovoNorma. Ua nānā ʻia kēia mau lāʻau lapaʻau no ka ʻike me ka kumu mua, he like ka like me ka hoʻohaʻahaʻa i ke kō a me ke ʻano, like me ka ʻike palekana palekana. Hoʻokomo ʻia nā kuhikuhi no nā lāʻau lapaʻau e like me ka hiki. ʻO nā ʻokoʻa i loko o ka noho pā i wehewehe ʻia e nā ʻano like ʻole o nā mea o nā mea kōkua. Hōʻike ka loiloi o nā maʻi maʻi i ka ʻula a me ka analogue ʻokoʻa wale nō i ka pepa o ka papa a me ka ʻaki. ʻO ke kumu o Diclinid he 126-195 mau rubles. i kēlā me kēia pā.

ʻO ka maʻi maʻi a me nā hoʻohaʻahaʻa manaʻo e hana ia i ka wā ma mua

• Ka hana maʻamau o ke kō -95%
• Hoʻokuʻuina o ka pua thrombosis - 70%
• Hoʻopau i kahi puʻuwai ikaika -90%
• Hoʻopau i ke kiʻekiʻe o ke koko - 92%
• ʻO ka hoʻonuiʻana i ka ikehu i ka wā, hoʻomaikaʻi i ka hiamoe i ka pō -97%

ʻO Iglinid ka mea hou o ka hoʻomākaukau ʻana no ka repaglinide i hoʻopaʻa ʻia ma Rū. Hoʻomaka maoli ka lāʻau lapaʻau i ka hōʻike ʻana i ka ʻoihana kūʻai. ʻAʻohe mau ʻike ʻana no Iglinid.

Ka hana lāʻau lapaʻau

ʻO ka repaglinide kahi huaʻai o ka benzoic acid. Hoʻopili ka mea i nā ʻenemi kūikawā i loaʻa i ka membrane o nā pū beta, poloka i nā kanika potasi, e wehe i nā kahawai calcium, a laila hoʻoulu ʻia i ka huna ʻana o ka insulin.

Hoʻomaka koke ka hana a ka repaglinide ma hope o ka lawe ʻana i ka piliki. Kahi ʻia ka hopena mua o ka lāʻau ma hope o 10 mau minuke, no laila hiki ke lawe ʻia ka lāʻau lapaʻau ma mua o ka ʻai. Loaʻa ka lōʻihi ma o nā moku ma hope o nā hola 40-60, e hiki ai iā ʻoe ke hoʻemi wikiwiki i ka glycemia postprandial. ʻO ka wikiwiki o ka normoglycemia ma hope o ka ʻai ʻana he mea koʻikoʻi loa mai ka manaʻo o ka pale ʻana i nā maʻi vascular ʻano maʻamau o ka maʻi mellitus. ʻO ka glucose kiʻekiʻe, e kū mau ana mai ka kakahiaka kakahiaka a hiki i ka wā hiamoe, hoʻomaikaʻi i ke kahe ʻana o ke koko, e hoʻomaikaʻi ana i nā hui koko, hana i nā lipid lipid, e alakaʻi i kahi mea kino i loko o nā ʻano palekana o nā kīʻaha koko, a e hoʻomau i ka hoʻonaninani mau.

ʻAʻole e like me derivatives sulfonylurea (PSM), ka hopena o ka repaglinide i hilinaʻi i ka glycemia. Ināʻoi aku i kahi 5 mmol / l, ʻoi aku ka hana o ka lāʻau lapaʻau ma mua o ke kō. Ua lilo koke ka lāʻau lapaʻau ma hope o ka hana, ma hope o ka hapalua hola o ka repaglinide i hoʻopau ʻia mai ke kino. Ma hope o 4 mau hola, ʻike ʻia ka ʻike paʻa o ka lāʻau i loko o ke koko ʻaʻole hiki ke hoʻopilikia i ka glycemia.

Loaʻa nā pōmaikaʻi pōkole o nā pōkole:

1. Hoʻohālike ka hana ʻana i ka insulin e like me ka mea maoli.
2. Hiki i ka hiki ke uku wikiwiki i ka maʻi diabetes.
3. ʻO ka hōʻemi o ka hopena o ka hypoglycemia. Ke lawe nei i ka repaglinide, ʻaʻole i hoʻopaʻa ʻia kahi hihia o ka hypoglycemic coma.
4. ʻO ka hapa o ka hyperinsulinemia hoʻomau. ʻO kēia ke kumu ʻaʻole nui ka loaʻa o ka maʻi maʻi.
5. Ke hoʻolōʻihi nei i ka beta cell lulule a me ka hoʻomau ʻana i ka maʻi diabetes.

Hoʻomili ʻia ka Repaglinide i loko o ka ate, 90% a i ʻole o ka nui o nā mea i hoʻopiʻi ʻia i loko o nā feces, a hiki i ka 8% o ka make i loaʻa i loko o ka urine. Kēia mau hiʻohiʻona o pharmacokinetics e hoʻohana i ka hoʻohana ʻana i ka lāʻau lapaʻau i ka manawa hope o ka nephropathy maʻi a me nā maʻi maʻi ʻē aʻe.

Nā hōʻailona no ka hoʻokomo

Hoʻokumu ʻia ʻo Repaglinide no nā maʻi maʻi 2 wale nō. Ke koi koi ʻia nā mea e pili ana i nā hana beta functioning. I nā Lūkini a me nā haole ʻē aʻe no ka mālama ʻana i ka maʻi mellitus o ka maʻi mellitus, ua helu ʻia nā glinides i ka lāʻau mālama mālama, ua kuhikuhi ʻia lākou i ka wā i pāpā ʻia ai nā papa ʻē aʻe.

Nā hōʻailona no ka hoʻohana ʻana:

1. ʻO kahi mana hou e pili ai i ka metformin, inā ʻaʻole ʻae ʻia a contraindicated paha. He mea kūpono ia no ka loaʻa ʻole o ka repaglinide i ka hopena o ka maʻi o ka cell i ka insulin, ua hōʻemi ʻia ke kōpaʻa ma o ke kū ʻana ʻana i ka pale ʻana o ka insulin e ka nui o ka hormone.
2. Ma kahi o nā derivatives sulfonylurea, inā loaʻa ka mea maʻi i ka maʻi ʻano maʻi i kekahi o nā lāʻau lapaʻau i kēia hui.
3. No ka hoʻonui ʻana i ka hoʻoponopono mālama ʻia, inā ua pau mua nā lāʻau lapaʻau e hoʻōla i ka pae o ka glucose kiʻekiʻe. Ke aʻo ʻia aku ʻae iā ʻoe e hoʻohui i ka repaglinide me ka metformin a me ka lōʻihi o ka insulin, thiazolidinediones. Me PSM, ʻaʻole hiki ke hoʻohana ʻia ka lāʻau lapaʻau no ka mea, ʻaʻole e kau i nā pihi i nā pancreas.
4. Wahi a nā kauka, ʻo ka repaglinide ua hoʻohana ʻia me ka maʻi maʻi ma ka maʻi maʻi e koi ana i kahi loli kūpono i ka papaʻaina o nā papa: me ka ʻai nui ʻana, ka papa ʻai ʻana, i ka wā hoʻomana.

E like me kekahi kīlaki maʻi, ʻo ka repaglinide e maikaʻi wale nō i ka hui pū me ka meaʻai a me ka hoʻomaʻamaʻa.

Hoʻoholo ʻia ka repaglinide

ʻAe nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana i ke kauoha ʻana i ka lāʻau lapaʻau i nā wahine hāpai a lactating, nā keiki a me nā maʻi maʻi ʻoi aku ka 75 mau makahiki ma mua o ka 75 makahiki, mai ka hōʻoia ʻana o ka palekana o ka repaglinide i kēia mau pūʻulu o nā maʻi.

E like me nā waha āpau hypoglycemic waha, ʻaʻole hiki ke hoʻohana ʻia ka repaglinide i nā hopena hoʻopiʻi o ka maʻi maʻi (ketoacidosis, hyperglycemic coma a me ka precoma) a i nā kūlana koʻikoʻi (hōʻeha, nā hana, nā mea wela a i ʻole nā ​​lēola, nā maʻi weliweli) - kahi papa inoa o nā hōʻeha āpau. Inā pono ke ʻano o ka maʻi maʻi i ka haukapila, ʻo ka hoʻoholo i ke kāpae ʻana i nā papa a hoʻoneʻe i insulin e hana ʻia e ke kauka komo.

I mea e hiki ai i ka lāʻau ke holo i ka hana wikiwiki, pono pono nā hana ʻoluʻolu. Ma ka hihia o ka paleka o ka ate, pāpā ʻia ka lāʻau me ka repaglinide e nā ʻōkuhi.

Inā lawe ka mea maʻi me ka maʻi mellitus i ka gemfibrozil no ka hoʻoponopono ʻana i ka pakanā lipid o ke koko, ʻaʻole pono ke kauoha ʻia ʻo NovoNorm a me Diagninid, no ka mea e hui pū ʻia ana lākou, hoʻāla ʻia ka repaglinide i ke koko ka nui a keu aku paha, a ua hiki ke hypoglycemia koʻikoʻi.

Nā Mana Kūʻai

Ua inu ʻoluʻolu ʻo Repaglinide ma mua o ka papa ʻaina (ʻaina kakahiaka, ʻaina awakea, ʻai ʻaina, ʻai). Inā iʻaila ʻia ka meaʻai i loko ʻaʻole ke kalaiwa, ʻaʻohe lawe i ka lāʻau lapaʻau. ^ E Ha yM. Wahi a nā loiloi, kūpono kēia hoʻoponopono lapaʻau i nā maʻi maʻi maʻi maʻi no ke ola kino, a no nā poʻe maʻi maʻi me ka makemake ʻole.

ʻO ka ʻikepili e pili ana i ka hoʻohana ʻana i ka lāʻau lapaʻau:

• ka pinepine o ka hoʻokipa - 2-4 manawa;
• manawa ma mua o ka papaʻaina :āpono ʻia - 15 mau minuke, ʻae ʻia - a hiki i ka hapalua hola;
• ʻo ka inumeta hoʻokahi hoʻomaka ka 0.5 mg no ka maʻi maʻi maʻi maʻi hou, 1 mg ke hoʻololi i ka repaglinide mai nā papaʻaila e hoʻohaʻahaʻa ana i ke kō;
• mahuahua ka lā inā ʻaʻole lawa ka pono o ka maʻi diabetes. Nā Kūlana - nā kiʻekiʻe o ke kō koko koko a me ka hemoglobin glycated;
• ka manawa ma waena o ka hoʻonui i ka dosage ʻokoʻa ma kahi hebedoma;
• ʻO ka nui loa he ʻehā he 4, i kēlā me kēia lā he 16 mg.

Wahi a nā ʻōmole hou, he lawe ʻole ka lawe ʻana i nā papa ʻaina gula i ka nui loa e like me ka hoʻonui ʻana o ko lākou hopena. Inā ʻaʻole e uku ka 2-3 mg o ka repaglinide i ka maʻi diabetes, pono ke hoʻohui i kekahi lāʻau lapaʻau hou, a ʻaʻole hoʻi e hoʻonui i ka dosis o kēia lāʻau lapaʻau i ka nui.

Nā hopena hopena

ʻO ka hopena maʻamau e pili ana i ka repaglinide he hypoglycemia. Hiki ia inā he nui ke hoʻokuʻu ʻia o ka insulin i loko o ke koko ma mua o ka mea e pono ai no ka hoʻohana ʻana o nā glucose hou. Aia ka hopena o ka hypoglycemia i nā mea pilikino: ka nui o ka lāʻau, ka ʻai ʻai, nā kūlana kaumaha, ka lōʻihi a me ka ikaika o ka hana kino.

Nā hopena ʻaoʻao a me kā lākou alapine e like me nā kuhikuhi i ka hoʻohana ʻana:

Hoʻohui nūhou

E hoʻonui i ka pae o ka repaglinide i ke koko a hoʻolōʻihi i kāna hana gemfibrozil, antibiotic clarithromycin a rifampicin, antifungals, immunosuppressant cyclosporin, MAO inhibitors, ACE inhibitors, NSAIDs, beta-blockers, salicylates, steroids, alkohol.

Contraceptives oral, derivatives o ka barbituric acid a me thiazide, glucocorticoids, antiepileptic carbamazepine, sympathomimetic lāʻau lapaʻau, hoʻāne nā huina thyroid i ka hopena o ka repaglinide.

Ke koho ʻana a kāpae i nā lāʻau lapaʻau i luna, e koi aku ke kūkākūkā a kauka a me ka mana glycemic pinepine.

Hoʻopili i nā kikowaena Repaglinide

ʻO ka analogue e pili kokoke ana i ka repaglinide ka pategy nateglin phenylalanine, he like ka like me ka hopena o ka mea kūpono. Hoʻokahi wale nō lāʻau me kēia mea hana i loaʻa ma Rusia - Starlix, mea hana iā NovartisPharma. Loaʻa iā Nateglide nona ma Iapana, nā ʻāpana iā lākou iho - ma Italia. ʻO ke kumu kūʻai o Starlix ma kahi o 3 tausani mau rubles no nā papa he 84.

Nā analogues kālā kūpaʻa - ka wānana PSM glibenclamide (Maninil), glycidone (Glurenorm), glyclazide (Diabeton, Diabetalong, Glidiab, etc.) a me ka glimepiride (Amaryl, Diamerid, etc.) ʻO PSM ka liʻiliʻi o ka repaglinide, ma muli o ka hopena.

ʻO Gliptins (Galvus, Januvia a me kā lākou mau analogue), i hana ʻia ma ke ʻano o nā papa a me ka inikini i hoʻohui ʻia i nā meletito (Baeta, Victoza) a me nā mea hana i hoʻomaikaʻi i ka synt synthesis. ʻO ke kumukūʻai o ka mālama ʻana me nā gliptins mai 1500 rubles. He ʻoi aku ka uku o ka Mimetic incretin, mai 5200 mau rubles.