ʻO Thiazolidinediones kahi hui hou o nā lāʻau lapaʻau waha antidiabetic. E like me biguanides, ʻaʻole lākou e kau i ka pancreas, hoʻoulu i ka hana o ka insulin endogenous, akā hōʻemi wale i ka pale ʻana o nā pūpū i ka hormone.
Hoʻopili i nā normally glycemia, hoʻomaikaʻi hou i nā lāʻau lapaʻau i ka hoʻopili lipid: e hoʻonui ka nui o ka HDL, e hoʻemi ka nui o ka triglycerol. Aia ʻo ka hopena o nā lāʻau lapaʻau e pili ana i ka hoʻoulu ʻia o ka palapala hoʻololi gen, hiki ke kali ʻia ka hopena maikaʻi loa mai ka mālama ʻana i 2-3 mau mahina. I nā hoʻokolohua lapaʻau, ʻo ka monotherapy me thiazolidinediones i hōʻemi i ka hemoglobin glycated i 2%.
Hoʻopili maikaʻi nā lāʻau lapaʻau o kēia pūʻulu me nā mea āpau antidiabetic - metformin, insulin, sulfonylurea derivatives. Hiki ke hui pū me ka metformin ma muli o kahi ʻano ʻokoʻa o ka hana: ʻo ka biguanides e kāohi ʻia i ka glucogenesis, a me ka thiazolidinediones e hoʻonui i ka hoʻohana ʻana i ka glucose.
ʻAʻole lākou e hoʻonāukiuki i ka hopena hypoglycemic i ka wā o ka monotherapy, akā, e like me ke metformin, i kahi hoʻomehana paʻakikī i nā lāʻau hypoglycemic hiki ke hōʻeha i kēlā mau hopena.
E like me nā lākaola e hoʻonui ai i ka ʻike ʻana i nā mea nānā i ka insulin, thiazolidinediones kahi o nā lāʻau lapaʻau maikaʻi loa no ka hoʻokele ʻana i ka maʻi type 2. ʻO ka hopena pale i hope o ka lawe ʻana i ka lāʻau lapaʻau e mau a hala 8 mau mahina ma hope o ka hopena.
Aia kahi hypothesis e hiki ai i nā lāʻau lapaʻau ke hoʻōla i ka genetic defect o ka metabolic syndrome, lohi i ka holomua o ka maʻi type 2 a hiki i ka lanakila piha ʻana o ka maʻi.
ʻO nā thiazolidinediones, ʻo ka rongoā lapaʻau ʻo ʻAtikala 2 o ka ʻoihana lapaʻau "Eli Lilly" (USA) i hoʻopaʻa ʻia ma ka mākeke Russian i kēia lā. Ke wehe nei kona hoʻohana i nā hana hou ʻaʻole wale i ka maʻi maʻi maʻi maʻi, akā ma ka cardiology hoʻi, kahi e hoʻohana ʻia ai ka lāʻau lapaʻau e pale aku i nā ala o nā puʻuwai a me nā kīʻaha koko, ma muli o ka pale ʻana i ka insulin.
Nā palapala helu a me ka hoʻopili ʻana o Pioglitazone
ʻO ka māhele maʻamau o ka lāʻau lapaʻau ka pioglitazone hydrochloride. I loko o kahi papa pākahi, ʻo kona huina e hilinaʻi ana i ka mahele - 15 a i ʻole 30 mg. Hoʻohui ʻia ka pūhui koʻikoʻi ma ka hoʻopili ʻana me ka lōpose monohidate, hydroxypropyl cellulose, calcium carboxymethyl cellulose, magnesium stearate.
Hiki ke hoʻomaopopo ʻia nā papa keʻokeʻo ʻē aʻe e ke ʻano convex a me ke kahakaha "15" a i ʻole "30".
I loko o kahi papa he 10 papa, i loko o kahi pahu - 3-10 mau papa papa. ʻO 2 mau makahiki kahi noho i ka pale o ka lāʻau. No ka pioglitazone, ʻaʻole hilinaʻi wale ke kumukūʻai ma ka hopena o ka lāʻau lapaʻau, akā naʻe i ka mea hana hoʻomohala: 30 mau papa o India Pioglar 30 mg kēlā me kēia mea ke kūʻai no ka 1083 mau rubles, 28 mau papa o Irish Actos 30 mg kēlā me kēia - no 3000 rubles.
ʻO nā hiʻohiʻona Pharmacological
ʻO Pioglitazone kahi lāʻau lapaʻau hypoglycemic waha o ka papa thiazolidinedione. Hoʻohana ka hana o ka lāʻau lapaʻau me ka hiki ʻana o ka insulin: e hoʻohaʻahaʻa ana i ka paepae o ke ʻano o ka ʻāʻī a me nā io i ka hormone, hoʻonui i ke kumukūʻai o ka glucose a hoʻēmi ʻia kona hana ʻana i ka ate. Hoʻohālikelike ʻia i nā lāʻau lapaʻau sulfonylurea, ʻaʻole e hoʻoulu ka pioglitazone i nā hua a nā kuleana no ka hoʻoulu ʻana i ka insulin a ʻaʻole e hoʻolako i ka ʻōpō a me ka necrosis.
ʻO ka emi ʻana o ke kū'ē o ka insulin i ka diabetes type 2 e kōkua i ka hoʻohālikelike i ka ʻike glycemic a me nā waiwai hemolele glycated. Me nā maʻi metabola, ua hāʻawi ka lāʻau lapaʻau i ka hoʻonuiʻana i nā pae HDL a me kahi emi o nā pae triglycerol. Hoʻomau ʻole nā ʻike o ka kolamu a me ka LDL.
Ke komo nei i ka digestive tract, hoʻōla ʻia ka lāʻau lapaʻau, hōʻea i nā waiwai palena i loko o ke koko ma hope o 2 mau hola me ka bioavailability o 80%. Ua hoʻonui ʻia ka hoʻonui ʻia ʻana o ka loaʻa ʻana o ka lāʻau lapaʻau ma ke koko no nā hala mai 2 a 60 mg. Loaʻa ka hopena paʻa ma hope o ka lawe ʻana i nā papa i nā lā 4-7 mua.
ʻAʻole e hoʻonāukiuki i ka hoʻohana ʻana i ka lāʻau. ʻAʻole hilinaʻi ka helu absorption i ka manawa i loaʻa i nā mea kanu.
Hoʻokuʻu ʻia ʻo Pioglitazone me nā feces (55%) a me ka waiʻai (45%). ʻO ka lāʻau lapaʻau, kahi i hoʻopuka ʻia i loko o kahi ʻano loli ʻole, he hapa hapalua o nā hola 5-6, no nā metabolites, 16-23 hola.
ʻAʻoleʻike ka makahiki o kahi maʻi maʻi i ka pharmacokinetics o ka lāʻau. Me nā renal dysfunctions, e hoʻohaʻahaʻa ʻia ka ʻike o ka glitazone a me nā metabolites, akā e like ka palaka ʻana, akā e hoʻomau ʻia ka paʻa ʻana o ka lāʻau lapaʻau.
Me ka hana ʻole o ka ate, ka mākaukau o ka nui o ka lāʻau i loko o ke koko, me ka piʻi ʻana o ka nui o ka māhele, e hoʻemi ʻia ka hoʻomaʻemaʻe, a e hoʻonui ʻia ka hapa o ka lāʻau lapaʻau.
Nā hōʻailona no ka hoʻohana ʻana
Hoʻohana ʻo Pioglitazone e kaohi i ka lolo type 2 like me ka monotherapy a me ka hoʻōla paʻakikī, inā i ka hoʻololi ʻana o ke ola (haʻalulu haʻahaʻa-kākoi, lawa ka hana kino, ʻona o ke kūlana kūloko) ʻaʻole e hoʻopiha piha no ka glycemia.
Ma ka hoʻomaʻamaʻa paʻakikī, ʻelua nā regimens me metformin e hoʻohana ʻia (ʻoi aku paha no ka momona), inā ʻo ka monotherapy me ka metformin i loko o ka wai therapeutic e hoʻolako i ka 100% glycemic control. I ka hihia o contraindications no ka metformin, hui pū me ka pioglitazone me nā lāʻau lapaʻau sulfonylurea, inā ʻaʻole ka hāʻawi ʻana o ka mea i ka hopena i loko o ka monotherapy i ka hopena i makemake ʻia.
Hiki i ka hui pū ʻana o ka pioglitazone a i loko o nā hui triple me ka metformin a me ka hoʻomākaukau ʻana no ka hoʻohālikelike ʻana, me ka mea kūpono no nā maʻi maʻi obese, inā ʻaʻole nā mākaukau mua e hāʻawi i kahi profil glycemic maʻamau.
Haʻa kūpono ʻia nā papa no ka diabetes-2 type-dependence like ʻole, inā ʻaʻole i lawa pono ka nui o nā inikini insulin i ka maʻi maʻamau, a ua hoʻohālikelike ʻia ka metformin a ʻaʻole i ʻae ʻia e ka mea maʻi.
Nā Hoʻohui
Hoʻohui i nā hypersensitivity i nā mea o nā loiloi, ʻaʻole i ʻōlelo ʻia ka pioglitazone:
- ʻO nā maʻi me ka maʻi ʻeha 1;
- Me ka ketoacidosis maʻi maʻi;
- ʻO nā maʻi me nā maʻi pēpē koʻikoʻi;
- Inā i loko o ka anamnesis - nā maʻi alahaka o nā ʻano. I - IV NYHA;
- Me ka macroscopic hematuria o ka etiology maopopo ʻole;
- Ma ka maʻi huka me ka oncology (ʻo ka maʻi kanesa.
Nā Hoʻohui Kūʻai
ʻO ka hoʻohana pū ʻana o ka pioglitazone me digoxin, warfarin, fenprocoumone a me ka metformin ʻaʻole e loli i ko lākou hiki i nā lāʻau lapaʻau. ʻAʻole pili i ka pharmacokinetics a me ka hoʻohana ʻana o glitazone me nā hua palapala sulfonylurea.
Nā hōʻike e pili ana i ka kamaʻilio ʻana o ka pioglitazone me ka contraceptives oral, blockers kalsi calcium, cyclosporine a me HMCA-CoA reductase inhibitors ʻaʻole i hōʻike i kahi hoʻololi i ko lākou mau hiʻohiʻona.
ʻO ka hoʻohana ʻana i ka pioglitazone a me gemfibrozil e hoʻonāukiuki i ka hoʻonui o ka AUC o glitazone, e hōʻike ana i ka hilinaʻi ʻana o ka manawa-manawa, ma 3 manawa. Hiki i ke kūlana ke hoʻonui i nā manawa kūpono o ke ʻano o nā hopena hilinaʻi-hilinaʻi, no laila, pono ke hoʻoponopono ʻia ka nui o ka pioglitazone i ka wā i hui pū ʻia me kahi inhibitor.
Hoʻonui ʻia ka nui o ka pioglitazone i ka wā e hoʻohana pū ʻia ai ʻo rifampicin. Kauka ʻia ka nānā ʻana i ka glycemia.
ʻO nā ʻōlelo ʻōlelo no ka hoʻohana ʻana o Pioglitazonum
Hoʻomaopopo nā kauoha a Pioglitazone no ka hoʻohana ʻana i nā mea maʻi maʻi hoʻohana i ka 1 p. / Lā. Ua hoʻohālikelike ʻia ka papa papa me ka wai, e koho ke kauka i ke ʻano ma ka noʻonoʻo ʻana i ke ʻano ma mua o ka makahiki, ka makahiki, ka makahiki o ka maʻi, nā ala e like ai, nā hopena o ke kino.
Me ka mālama paʻakikī me ka insulin, e hoʻoponopono ʻia ke ʻano o ka hopena o ka wā e like me ka heluhelu ʻana o ka glucometer a me nā hiʻohiʻona ʻai.
No nā maʻi maʻi maʻi kahiko, ʻaʻohe pono e hoʻololi i ka dosage, hoʻomaka lākou me kahi haʻahaʻa haʻahaʻa, hoʻonui i ka liʻiliʻi, ʻoiai me nā kumu hoʻohui - e hoʻomaʻamaʻa kēia i ka hoʻololi ʻana a hōʻemi i ka hana o nā hopena ʻaoʻao.
Me nā ʻāpana renal (hoʻopili o ka hana ma mua o 4 ml / min.), Ke kuhikuhi ʻia nei ʻo Glitazone e like me ka mea maʻamau, ʻaʻole i hōʻike ʻia no nā maʻi maʻi hemodialysis, me ka pūʻala o ka huhū.
Nā ʻōlelo ʻokoʻa
ʻO ka maikaʻi o ka regimen i koho ʻia e loiloi i kēlā me kēia 3 mahina e hoʻohana ana i ka assly hemoglobin glycated. Ināʻaʻohe ʻano kūpono, hoʻopau i ka lāʻau lapaʻau. ʻO ka lōʻihi o ka hoʻohana ʻana i ka pioglitazone e lawe i ka hopena hiki, no laila, pono ke kauka e nānā i ka ʻike palekana o ka lāʻau.
Hiki i ka lāʻau lapaʻau ke mālama i ka wai i loko o ke kino a hoʻomaʻamaʻa i ke kūlana i ka palau o ka naʻau. Inā loaʻa i kahi maʻi maʻi ka hopena o ke ʻano ʻelemakule, he hōʻeha puʻuwai a i ʻole ka maʻi ʻōpū coronary, pono ke ʻano liʻiliʻi.
Hiki i ka Titration me ka dinamics kūpono. Pono kēia ʻano o nā maʻi āpau i ka mālama maʻamau ʻana i ko lākou kūlana olakino (ka nui, ke kaumaha, nā hōʻailona o ka maʻi puʻuwai), ʻoiai me kahi haʻahaʻa diastolic haʻahaʻa.
Pono e ʻike pono i ke koho ʻana i kahi lāʻau lapaʻau i ka maʻi maʻi o ka makua (mai 75 mau makahiki), ʻoiai ʻaʻohe ʻike me ka hoʻohana ʻana i ka lāʻau lapaʻau no kēia ʻāpana. Me ka hui pū ʻana o ka pioglitazone me ka insulin, e hoʻonui ʻia nā pehu cardiac. I kēia manawa, ʻo ke ala o ka ʻōpū o ka maʻi ʻaila, ke piʻi nei ka pōpilikia, no laila, i ke kuhikuhi ʻana i ka lāʻau lapaʻau, pono e loiloi i ka pōmaikaʻi maoli a me nā hōʻeha maoli.
Hoʻokomo ʻia nā hoʻokolohua haukapila i ka nui o ka hoʻomohala ʻana i ka maʻi kanesa aʻai ma hope o ka ʻai ʻana i ka pioglitzone. ʻOiai ʻo ka haʻahaʻa haʻahaʻa (0,06% kū'ē 0.02% i ka hui hoʻokokoke), ʻo nā mea āpau e hoʻonāukiuki i ka maʻi kanesa (ka ulaula, ka hōʻino ʻana i ka hōʻeha, hoʻoweliweli ʻia o ka pelvic, makahiki) pono ke loiloi ʻia.
Ma mua o ke koho ʻia ʻana o ka lāʻau lapaʻau, ʻike ʻia nā mākina ati. Me ka hoʻonui o ALT e ka 2 mau manawa a me ka mālama ʻole o ka nalo, ua contraindicated ka lāʻau lapaʻau. Me ka kaumaha o ka naʻau o nā pathologies, maʻa ka pioglitazone me ka makaʻala.
Me nā hōʻailona o ka hoʻopiʻi hepatic (pilikia dyspeptic, ʻeha ʻo ka maʻi epigastric, anorexia, mauʻano mau), nā ʻano hana ʻepekika. ʻO ka hoʻolilo i ka maʻamau ma 3 mau manawa, a me ka hiʻohiʻona o ka hepatitis, pono ke kumu no ka haʻalele ʻana i ka lāʻau.
Me ka hoʻohaʻahaʻa ʻana i ka pale ʻana i ka insulin, kahi hoʻihoʻi hou ʻana o ka momona: e hoʻohaʻahaʻa ka visceral, a hoʻonui hou ka ʻōpū. Inā pili ke kaupaona ʻana me ka edema, pono ia e pale i ka hana o ka naʻau a me ka helu calorie.
Ma muli o ka hoʻonui nui o ke koko, hiki i ka hemoglobin ke emi e ka awelika o 4%. Hoʻomaopopo nā ʻano like like i ka wā e lawe ai i nā lāʻau lapaʻau antidiabetic ʻē aʻe (no ka metformin - 3-4%, hoʻomākaukau ʻana o ka sulfonylurea - 1-2%).
I ka hui pū ʻana pālua a me ka triple me ka pioglitazone, ka nui a me ka hāahi a me ka ʻonopuna o ka sulfonylurea, e hoʻonui ʻia ka pā o ka hypoglycemia. Me ka lāʻau paʻakikī, titration manawa o ka nui.
Hiki i ke Thiazolidinediones ke hāʻawi i ka ʻike a me ka holo ʻana o ka pilikia. Ke hoʻokipaʻana i kahi ophthalmologist, mea nui ia e noʻonoʻo i ka hopena o ka macular edema me pioglitazone. Aia kahi pilikia o nā haʻalulu iwi.
Ma muli o ka lawa ʻole o ka hōʻike hōʻike no ka holomua a me ka palekana e pili ana i ka wā hāpai a me ka lactation, ʻaʻole i kuhikuhi ʻia nā wahine i ka polyglitazone i kēia mau manawa. Hoʻokomo ʻia ka lāʻau i ka wā kamaliʻi.
Ke hoʻokele nei i nā kaʻa a i ʻole nā ʻenehana paʻakikī, pono e noʻonoʻo ʻia ka hopena o ka ʻaoʻao ma hope o ka hoʻohana ʻana i ka glitazone.
ʻO nā hopena pākuʻi a me nā hemahema
Me ka monotherapy a ma nā hana paʻakikī, ua hoʻopaʻa ʻia nā mea iʻike ʻole ʻia.
- ʻO ka edema Macular, ʻike maka;
- Anemia
- Hypersthesia, poʻomanaʻo;
- ʻO nā paʻi o ka pūnao hoʻopili, sinusitis a me ka pharyngitis;
- Allergy, anaphylaxis, hypersensitivity, angioedema;
- Hoʻemi i ka maikaʻi o ka hiamoe;
- Hoʻokumu i nā ʻano ʻano like ʻole: polyps, cysts, cancer;
- Nā hopena a me nā ʻeha i nā kekee;
- Hoʻopiʻi i ka ritika maʻa;
- ʻĀina Erectile;
Hypoglycemia, ʻaʻohe keʻakeʻa ʻole;- Hypesthesia, pale hoʻopōʻino;
- Vertigo;
- Loaʻa kaʻili a me ka ulu ALT;
- ʻO Glucosuria, proteinuria.
Hypoglycemia, ʻaʻohe keʻakeʻa ʻole;Ua hoʻāʻo ka noiʻi ʻana i ka palekana o kahi kaʻe o ka 120 mg, kahi i lawe ai nā mea hana ma nā lā 4, a laila 7 mau lā hou ma 180 mg. ʻAʻole i loaʻa nā hōʻailona overdose.
Hiki i nā kūlana Hypoglycemic me ka hoʻoponopono lāʻau paʻakikī me ka hoʻomākaukau ʻana o ka insulin a me ka hoʻomākaukau ʻana o ka sulfonylurea. Hāʻawi ka Therapy a me ke kākoʻo.
Pioglitazone - hui kikowaena
I ka mākeke US no antibiotics, ʻo kekahi o nā mea nui i ka honua, noho ʻo ka pioglitazone i kahi mahele e like me ka metformin. Me nā contraindications a palaka paha, hiki ke hoʻololi ʻia ka pioglitazone e Avandia a i Roglit - nā analogues e pili ana i ka rosiglitazone - kahi hua lāʻau o ka papa o ka thiazolidinediones, akā naʻe, he pōmaikaʻi nā wā lōʻihi i kēia pūʻulu.
E hōʻemi i ka pale o ka insulin a me nā biguanides. I kēia hihia, hiki ke hoʻololi ʻia ka pyoglizatone e Glucophage, Siofor, Bagomet, NovoFormin a me nā lāʻau lapaʻau e pili ana me ka metformin.
Mai ka māhele kālā o nā lāʻau lapaʻaka hypoglycemic, mea kaulana nā mea analogues Lūkini: Diab-norm, Diaglitazone, Astrozone. Ma muli o kahi papa inoa o nā contraindications, ʻo ka nui o ka e hoʻonui me ka hōʻuluʻulu paʻakikī, pono e mālama pono kekahi me ka koho o nā analogues.
Ka loiloi ʻana i nā mea kūʻai
E pili ana i ka pioglitazone, ua hui pū ʻia nā loiloi o nā maʻi maʻi maʻi. ʻO ka poʻe i lawe i nā lāʻau lapaʻau mua e hoʻomaopopo i ka hana kiʻekiʻe a me ka liʻiliʻi o ka hopena ʻaoʻao.
ʻO ka hopena ka mea kūlike: ʻo ka lāʻau lapaʻau ka hoʻēmi loa ʻana i ka pae o ka glycemia, glycated hemoglobin a me ka pono o ke kūmole (me ka maʻi maʻamau.) Akā, ʻaʻole kūpono ia no nā poʻe a pau, no laila, ʻaʻole ʻoe e hoʻokolohua me ka olakino, ka loaʻa ʻana o ka lāʻau lapaʻau ma luna o ka ʻōlelo aʻo a nā hoaaloha. ʻO kahi mea loea wale nō ke hiki i ka hoʻoholo i ka hiki ke hoʻopaʻa ʻia o ia ʻano lāʻau a me ka algorithm no ka loaʻa ʻana i ka pioglitazone.
Hiki iā ʻoe ke aʻo hou e pili ana i ka hoʻohana ʻana o thiazolidinediones i loko o nā hana ʻoihana ma loko o ke wikiō:
