ʻO Pioglitazone - kahi lāʻau lapaʻau no nā maʻi maʻi type 2

ʻO Pioglitazone kahi lāʻau lapaʻau hou hoʻēmi hou; ua hoʻokomo ʻia i loko o ka hoʻomaʻamaʻa ʻana ma ka 1996. Aia ka waiwai i ka pūʻulu o thiazolidinediones, ke ʻano o ka hana i loko o ia mea e hoʻonui ai i ka ʻike ʻana o ka ʻiʻo māiwi a me ka momona i ka insulin. ʻAʻole pili pololei ʻo Pioglitazone i ka pae o ka hēnā ʻia o ka hormone. Hoʻomaopopo maikaʻi ia ka lāʻau, ʻaʻole ia i ka hypoglycemia, he hopena maikaʻi ma ka lipid metabolism. Hōʻike ia i ka hopena hypoglycemic maikaʻi loa i nā maʻi momona momona.

ʻO ka hana o ka hana pioglitazone

ʻO ka hōʻemi ʻana i ka naʻau o ka insulin, kekahi o nā kumu lalo o ka hōʻike ʻana i ka maʻi diabetes. Hiki i ka Pioglitazone ke hōʻemi i ka pale ʻana i ka insulin, ka mea e alakaʻi ai i ka pohi ʻana o ka gluconeogenesis i loko o ka ate, a he emi iho i ka hoʻāʻo ʻana o nā momona momona i loko o ke koko, a me ka hoʻonui ʻana i ka hoʻohana ʻana o ka puhipuhi e nā kino kūwili. I ka manawa like, emi ka glycemia, hoʻonaninani ka lula o ke koko, a hoʻoheheʻe ʻia ka protein glycation. Wahi a nā noiʻi, hiki i Pioglitazone ke hoʻonui i ka hoʻonui ʻia o ka glucose i ka wā e 2.5 mau manawa.

Ma ka ʻōlelo maʻamau, ua hoʻohana ʻia ka metformin e hōʻemi i ka pale ʻana i ka insulin. Hoʻonui kēia mau mea i ka hoʻololi ʻana o ka hormone a nui i loko o ka ate. I nā io a me nā kele adipose, ʻike ʻia kona hopena. ʻO ka Pioglitazone e hōʻemi i ka pale aku i ka momona a me ka puʻuwai, ka nui o ka ikaika o ka metformin. Ua hoʻohālikelike ʻia ʻo ia ma ka lālani laina lua ke ʻole ka hopena o ka metformin (ʻoi aku me ka maʻi koʻikoʻi a me ka haʻahaʻa haʻahaʻa) a i ʻole ʻia e ka maʻi maʻi maʻi maʻi.

Ma ke ala o ka mālama ʻana me Pioglitazone, ka hopena o ka hopena o ka glucose a me nā lipids ma nā puna beta a me nā kōpila peripheral i emi iho, no laila e māhuahua ka hana o nā seleka beta, e hoʻomau ka pae o kā lākou make, e hoʻomaikaʻi ka synt synthesis.

I nā ʻōlelo kuhikuhi no ka hoʻohana ʻana, ua ʻike ʻia ka hopena maikaʻi o Pioglitazone ma luna o nā kumu o nā hoʻopiʻi maʻi cardiovascular diabetes. Ma hope o 3 mau makahiki o ka hoʻokele ʻana, hāʻule ka nui o ka triglycerides ma ka awelika o ka 13%, hoʻonui ʻia ka "maikaʻi" e ka 9%. Hoʻemi ʻia ka pilikia o ka hōʻeha a me ka ʻeha o ka naʻau ma ka 16%. Ua hōʻike ʻia i loko o ka hoʻokolohua me, i ke kaʻe o ka hoʻohana ʻana o Pioglitazone, ʻo ka mānoanoa o nā paia o nā kahe koko e hoʻonaninani nei, ʻoiai ka hopena o ka maʻi maʻi o ka maʻi maʻi o ka maʻi maʻi.

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%

ʻAʻole hāʻawi ʻo Pioglitazone i ka loaʻa ʻana o ke kaumaha koʻikoʻi, e like me nā lāʻau lapaʻau e pili ana i ka synthesis o ka insulin. Ma kahi kaʻawale, i nā mea maʻi me ka maʻi maʻi maʻi he nui ka emi ʻana o ka ʻōpū o ka ʻōpū ma muli o ka emi ʻana o ka nui o ka momona visceral.

Pharmacokinetics o Pioglitazone e like me ke kauoha: Ma hope o ka lawelawe waha, ua komo ke kino i ke kahe ma hope o ka hapalua hola. Hiki i ka līlihi kiʻekiʻe ma 2 mau hola inā e ʻawa nā papa i ka ʻōpū ʻole, a i kahi hola 3,5 inā lawe ʻia lākou me ka meaʻai. Hanaʻia ka hana ma hope o ka paona hoʻokahi no ka liʻiliʻi loa i ka lā. E kū aku i ka 30% o Pioglitazone a me nā mea hoʻokolohua o loko o ka pāʻai, ʻo ke koena me nā feces.

Hoʻomākaukau Pioglitazone

ʻO ka lāʻau kanu mua o Pioglitazone ua manaʻo ʻia ʻo Aktos i hana ʻia e ka hui lāʻau lapaʻau ʻAmelika ʻo Eli Lilly. ʻO ka mea waiwai i nā papa pili ʻo Pioglitazone hydrochloride, a me nā mea kōkua pūnaʻi he cellulose, magnesium stearate a lactose. Loaʻa ka lāʻau lapaʻau i nā dosages o 15, 30, 45 mg. I kēia manawa ua kākau inoa ʻo Aktos ma Lūkia, ʻaʻole i hoʻopaʻa inoa ʻia ka lāʻau lapaʻau, no laila ʻaʻole hiki iā ʻoe ke kūʻai iā ia i loko o nā hale kūʻai. Ke kauoha ʻana mai ʻEulopa, ʻo ke kumukūʻai o kahi ʻeke Aktos e like me 3300 rubles. nā pāʻaina he 28 papa.

ʻO nā kumukūʻai ma Rusia e uku nui aku. No ka laʻana, ʻo ka kumukūʻai o Pioglar e pili ana i 400 mau rubles. no nā papa 30 o 30 mg. ʻO nā hoʻomākaukau e hiki mai a Pioglitazone i hoʻopaʻa ʻia i loko o ka hale kākau mokuʻāina.

ʻO kēia mau lāʻau āpau he hoʻopau piha ʻana o Aktos, ʻo ia hoʻi, hoʻihoʻi hou lākou i ka hopena pharmacological o ka lāʻau mua. ʻO ka hoʻokō kaulike e hōʻoia ʻia e nā haʻawina hoʻokolohua. Akā ʻaʻole mau like nā loiloi o ka maʻi maʻi me lākou, hilinaʻi ka poʻe iā Aktos i nā mea hou aku.

Nā hōʻailona no ka hoʻokomo

Hoʻohana ʻia ʻo Pioglitazone e hōʻemi i ka glycemia wale nō i ka maʻi maʻi type 2. E like me nā mea āpau antidiabetic waha, ʻaʻole hiki i Pioglitazone ke hopena i ka kō koko koko inā ʻaʻole i hoʻoponopono ka maʻi maʻi i kona ʻano. Ma kahi liʻiliʻi liʻiliʻi, pono ʻoe e hōʻemi i ka nui o nā mea kālai a ʻona i hoʻopau ʻia, a me ka nui o ke kaumaha - a me nā kalona, ​​e kau i loko o kēlā me kēia hana maʻamau. No ka hoʻomaikaʻi ʻana i ka glycemia postprandial, pono ʻoe e haʻalele i nā meaʻai me ka GI kiʻekiʻe mai ka meaʻai, e hoʻokaʻawale i nā hāmeʻe like ʻole no nā pāʻina āpau.

Hoʻohana pū ʻo Pioglitazone ma ke ʻano o ka monotherapy, akā ʻoi aku ka pinepine o ke ʻano me ka hōʻuluʻulu ʻana me ka nui o nā mea maʻi hypoglycemic. ʻAe nā ʻōlelo e hoʻohana ai iā ʻoe e hoʻohana iā Pioglitazone i hui pū me ka metformin, sulfonylureas, insulin.

Nā hōʻailona no ka koho ʻana i nā papa:

1. Na mellitus maʻi maʻi hou i nā maʻi momona keu, inā ua loaʻa ka maʻi diabetes i nā contraindications no ka hoʻohana (renal failed) a i ʻole ka palaka maikaʻi (hoʻopuka, ʻaʻai) o ka metformin.
2. Me ka metformin i ka maʻi diabetes obese inā ʻaʻole i lawa ka metformin monotherapy e hoʻomaʻamaʻa i ke kō.
3. I ka hui pū ʻana me ka mākaukau sulfonylurea, inā he kumu e manaʻoʻiʻo ai ka hoʻomaka ʻana o ka mea maʻi i ka hoʻoneʻeneʻe ʻana i ka syntyp o kāna insulin.
4. ʻO ka maʻi diabetes i hilinaʻi ʻia, inā e koi aku ka mea maʻi i nā dosis kiʻekiʻe o ka insulin ma muli o ka haʻahaʻa o nā kaila o ia mea.

Nā Hoʻohui

Ke papa ʻia nei ke aʻo e lawe iā Pioglitazone ma kēia mau pilikia aʻe:

• inā ʻike ka hypersensitivity i ka liʻiliʻi o kekahi o nā mea o ka lāʻau. ʻO ke ʻano o nā maʻi kūlohelohe i ke ʻano o ka heʻe a i ʻole ka palaka i ʻole e koi ai i ka hoʻokuʻu ʻana o ka lāʻau;
• me ka maʻi type diabetes mellitus, ʻoiai inā he maʻi kūlohelohe ka maʻi;
• i nā keiki maʻi maʻi;
• i ka wā hāpai a me ka HB. ʻAʻole i lawelawe ʻia nā haʻawina i kēia mau hui o ka maʻi maʻi me ka maʻi maʻa, no laila ʻaʻole maopopo ʻia inā Pioglitazone ke kālai i ka palaki placental a i loko o ka waiū. Hoʻopaʻi koke ʻia nā papa i ka wā i hoʻokumu ʻia ai ka hapai ʻana;
• nāʻeha kaumaha o ka naʻau;
• i nā hana ʻoi e koi ai i ka hoʻomehana ʻana o ka insulin (nā hōʻeha hōʻeha, nā maʻi maʻi a me nā maʻi o ka laʻana, ketoacidosis), kāpae ʻia nā papa āpau hypoglycemic āpau.

Ke kauoha nei ke aʻoaʻo i ka lawe ʻana i kēia lāʻau lapaʻau me ka mālama aka ʻana i ka hihia o ka edema, anemia. ʻAʻole ia he contraindication, akā koi ka hōʻohi ʻana i ka puʻukū i nā mākaʻi hou aku. Me ka nephropathy, hiki ke hoʻohana ʻia ʻo Pioglitazone ma mua o ke ʻano o ka metformin, no ka mea, ʻoi aku ka nui o nā mea i hoʻohālikelike ʻia e nā keiki.

Pono ka nānā ʻana i ke koho ʻana o Pioglitazone no kekahi maʻi maʻi. ʻO kona hui kikowaena kikowaena, rosiglitazone, i hōʻike i ka nui o ka hōʻeha o ka myocardial infarction a me ka make mai nā mea ʻē aʻe o ka naʻau. ʻAʻole i loaʻa iā Pioglitazone kahi hopena e like me, akā, ʻo nā mea āpau hou aku i ka wā e lawe mau ai ʻaʻole e hoʻopilikia. Wahi a nā kauka, hoʻāʻo lākou e pāʻani me ka palekana a ʻaʻole i kuhikuhi iā Pioglitazone me ka liʻiliʻi loa o ka huhū o ka puʻuwai.

Hoʻohui nūhou

Me ka hoʻohana pū ʻana o Pioglitazone me nā lāʻau lapaʻau ʻē aʻe, hiki i ka loli ke hiki i ko lākou pono.

Ma nā lāʻau ʻē aʻe, ʻaʻohe mea i ʻike pū ʻia me Pioglitazone.

Nā rula no ka lawe ʻana iā Pioglitazone

ʻO kahi kumu o ka dosage, inu nui ʻo Pioglitazone i hoʻokahi lā i ka lā maʻi. ʻAʻole koi ʻia nā palena kai.

Ke kaʻina koho ʻauana:

1. Ke hoʻomaka nei ma kahi hoʻomaka, inu i 15 a 30 mg nō. No nā maʻi kamepika o ka momona, ʻōlelo ke aʻo ʻana e hoʻomaka i ka mālama ʻana me 30 mg. Wahi a nā loiloi, me ka hui pū pūpū me ka metformin, 15 mg o Pioglitazone i kēlā me kēia lā ka lawa no ka nui.
2. Hōʻemi iki ka lāʻau lapaʻau i ka pale ʻana i ka insulin, no laila ua paʻakikī ka loiloi ʻana i kona pono me kahi mika glucose koko home. Pono ka maʻi maʻi maʻi ma ka kuʻina e nānā i ka hemoglobin glycated. Hoʻonui ʻia ka nui o ka Pioglitazone e 15 mg inā, ma hope o 3 mau mahina e lawe ai i ka GH, noho mau ia ma luna o 7%.
3. Inā hoʻohana ʻia ʻo Pioglitazone e like me ka sulfonylurea a i ʻole insulin, e ulu ka hypoglycemia i nā maʻi me ka maʻi maʻi. I kēia hihia, pono ʻoe e hōʻemi i ka papaʻa o nā lāʻau lapaʻau hou, e waiho ʻia ana ka nui o Pioglitazone. Hōʻike nā loiloi o nā mea maʻi me ka pale ʻana i ka insulin e hiki ke hōʻemi i ka lāʻau i ka nui o ka insulin i hoʻohana ʻia e ka ʻekahi hapaha.
4. ʻO ka nui loa ka nui o ka ʻimi no ka maʻi maʻi no 45 mg me ka monotherapy, 30 mg i ka wā e hoʻohana pū ai me nā lāʻau lapaʻau haʻahaʻa. Inā ma hope o 3 mau malama o ka lawe ʻana iā Pioglitazone ma kahi nui loa, ʻaʻole i hoʻi mai ʻo GH i ka maʻamau, ua hāʻawi ʻia kekahi maʻi maʻi i kahi lāʻau e pale ai i ka glycemia.

Nā hopena hopena

Hoʻohālikelike ʻia ke koho ʻana o Pioglitazone ma ka hana lapaʻau e nā hopena maikaʻi ʻole o ka waihona, ʻoi aku ka nui me ka hoʻohana mau ʻana:

1. I nā mahina ʻeono, i ka 5% o nā maʻi maʻi, e mālama pū ana me Pioglitazone i ka hui pū me ka sulfonylurea a i ʻole insulin e hele ʻia me ka hoʻonui o ka paona a hiki i ka 3,7 kg, a laila hoʻomau kēia kaʻina. Ke lawe ʻia me ka metformin, ʻaʻole e hoʻonui nui ke kino o ke kino. Ma ka maʻi mellitus, he mea nui kēia hopena maikaʻi loa, no ka mea, nui ka maʻi o ka maʻi. I mea e pale ai i ka lāʻau lapaʻau, pono e ʻōlelo ʻia ka nui o ka nui ma o ka momona subcutaneous, a me ka nui o ka momona momona visceral, ma ke ʻano ʻē, e emi ana. ʻO ia, ʻoiai ka loaʻa o ka paona, ʻaʻole kōkua ʻo Pioglitazone i ka hoʻomohala ʻana o nā vascular koi i ka maʻi maʻi.
2. Hoʻomaopopo kekahi mau poʻe maʻi i ka mālama ʻana i ka wai ma ke kino. Hōʻike ka ʻōlelo no ka hoʻohana ʻana i ka lōʻihi o ka nānā ʻana o ka edema me ka monogio Pioglitazone o 5%, me ka insulin - 15%. Hoʻomai ʻia ka mālama wai me ka hoʻonui o ka nui o ke koko a me ka wai o ka extracellular. ʻO ia me kēia hopena hopena ua pili nā hihia o ka puʻuwai puʻuwai e pili ana i ka hoʻokō ʻana o Pioglitazone.
3. Hiki ke mālama pū ʻia ka hoʻomaʻamaʻa ʻana me ka liʻiliʻi o ka hemoglobin a me ka hematocrit. ʻO ke kumu ke mālama mau nei, ʻaʻohe hopena o nā mea make i ke kaʻina hoʻomehana i ke koko.
4. Me ka hoʻohana mau ʻana o rosiglitazone, kahi analogue o Pioglitazone, kahi i hoʻemi ʻia i ka iwi o ka iwi a me ka nui o ka loaʻa o nā puʻupuʻu i loaʻa. No Pioglitazone, ʻaʻohe data like.
5. I ka 0.25% o nā maʻi me ka maʻi mellitus, ua ʻike ʻia kahi piʻi ʻekolu ʻekolu o nā pae ALT. I nā kū kaʻawale, ua hōʻike ʻia ka maʻi hepatitis.

Ke olakino olakino

Pono ka hoʻohana ʻana o Pioglitazone e nānā hou i ke kūlana olakino o ka maʻi maʻi.

Pehea e hoʻohuli ai iā Pioglitazone

No nā mea e pili ana i ka pūʻulu thiazolidinedione, ua hoʻopaʻa wale ʻia ka rosiglitazone ma Rū ʻokoʻa ʻo Pioglitazone. ʻO ia ka mahele o nā lāʻau lapaʻau Roglit, Avandia, Avandamet, Avandaglim. Ua hōʻike ʻia nā haʻawina ʻo ka mālama lōʻihi me ka rosiglitazone e hoʻonui i ka nui o ka hōʻeha o ka naʻau, ka make mai ka myocardial infarction, no laila ua kuhikuhi ʻia ia wale nō me ka loaʻa ʻole o kahi koho aʻe.

Hoʻohui aku iā Pioglitazone, nā lāʻau lapaʻau e pili ana i ka metformin e hōʻemi i ka pale o ka insulin. E hoʻomaikaʻi i ka hoʻomanawanui o kēia kumuhana, ua hana ʻia nā papa hoʻohālike i hoʻoponopono ʻia - Ua hoʻāla ʻia nā Glucofage Long a me nā analog.

ʻO nā rosiglitazone ʻelua a me ke metformin he mau contraindications, no laila hiki ke kuhikuhi ʻia e kāu kauka wale nō.

Hōʻikeʻike i nā kauka a me nā maʻi

Ua hoʻokaʻawale loa nā poʻe Endocrinologists i ka pioglitazone. ʻO ke kumu o kā lākou makemake ʻole ʻana i kēia lāʻau lapaʻau, kāhea lākou i ka pono no ka mālama ʻana i ka hemoglobin a me nā hana ate, he koʻikoʻi ke kau ʻana i ka lāʻau lapaʻau no ka angiopathy a me nā mea maʻi maʻi, ka mea e pae ai ka hapa nui o nā maʻi. ʻO ka hapa pinepine, manaʻo nā kauka iā Pioglitazone he koho no ka metformin i ka hiki ʻole ke hoʻohana, ʻaʻole like me ka hypoglycemic kūʻokoʻa.

I nā maʻi maʻi, ʻaʻole kaulana kekahi o Pioglitazone. ʻO kahi pale koʻikoʻi o kona hoʻohana ʻana ʻo ke kumukūʻai kiʻekiʻe o ka lāʻau lapaʻau, ka hiki ʻole ke loaʻa me ka manu ʻole. ʻAʻole hiki i ka lāʻau lapaʻau ke loaʻa i kēlā me kēia lāʻau lapaʻau, ʻaʻole hoʻi hoʻohui i kāna mea kaulana. ʻO nā hopena o ka lāʻau lapaʻau, ka nui o ka loaʻa ʻana o ke kaumaha, a ʻike pinepine ʻia ka ʻike e pili ana i ka hopena o ka maʻi o ka puʻuwai ke lawe nei ka glitazones i nā mea maʻi me ka maʻi maʻi.

Ua hoʻohālikelike ʻia nā papa ʻōlelo maʻamau e nā poʻe maʻi ʻoi loa ka maikaʻi a me ka palekana. Ke hilinaʻi nui nei lākou i ka hana o ka generics, ke makemake nei i ka hana ʻana me nā ʻano kuʻuna: metformin a me sulfonylureas