Pioglitazone (Pioglitazone)

A na-emepụta ọgwụ ahụ n'ụdị mbadamba: site na nke na-acha ọcha ruo ọcha, gburugburu, 15 mg - biconvex, nke etinyere n'otu akụkụ nke "15", 30 mg - flat, with a bevel, a kanyere ya n'otu akụkụ nke "30" (10 PC. na ọnya, 1, 3 ma ọ bụ 5 blisters na ntuziaka maka iji Pioglara na igbe kaadi).

Otu mbadamba 1 nwere:

• ihe na - arụ ọrụ: pioglitazone hydrochloride - 16.53 ma ọ bụ 33.07 mg, nke ya na pioglitazone dị na 15 na 30 mg, n'otu n'otu
• ihe ndị ọzọ: calcium carboxymethyl cellulose, magnesium stearate, hydroxypropyl cellulose (viscosity dị ala), lactose, mmiri dị ọcha.

Mlọ ọgwụ

Pioglitazone bụ onye na-ekwu okwu hypoglycemic na-ahụ maka ọnụnụ, ihe sitere na usoro thiazolidinedione, na-ahọrọ ndị na-anabata ya na-eme ka onye na - eme mkpọtụ peroxisome (PPARγ) rụọ ọrụ. A nabata ndị na-anabata PPARγ na anụ ahụ ndị dị nnukwu mkpa na usoro nke insulin (akwara akwara, anụ ahụ adipose na imeju). Ccụrị ọγụ nke ndị nabatara ngwa ngwa PPARγ na-emegharị ntụgharị nke ọtụtụ mkpụrụ ndụ ihe na-emetụta insulin ma na-etinye aka na nchịkwa nke glucose ọbara na metabolism lipid. Pioglitazone na-enye mbelata insulin iguzogide, n'ihi nke oriri nke glucose na-adabere insulin, ngafe nke glucose na mwepụta ya na imeju na-ebelata. Akụrụngwa nọ n'ọrụ na-enyere aka belata triglycerides, mee ka ịba ụba nke lipoproteins densens (HDL) na cholesterol dị elu. Pioglar adịghị akpali mmepụta nke insulin, n'adịghị ka ihe ndị na-emepụta sulfonylurea.

Mlọ ọgwụ

Mgbe nchịkwa ọnụ gasịrị, a na-ahụ nnabata pioglitazone nke dị elu, na plasma ọbara a na-achọpụta ihe na-arụ ọrụ mgbe nkeji 30 gasịrị, ịta kachasị (C_max) ana - enweta ya mgbe elekere abụọ gachara, yana iri nri - ka awa 3-4 gachara. Onye na-ahụ maka ọrụ na-ejikọ protein protein plasma kpamkpam - site na 99%, olu nke nkesa (V_d) 0.22-1.04 l / n'arọ. Pioglitazone bụ metabolized site na hydroxylation na oxidation, metabolites guzobere n'ihi biotransformation nke ihe ahụ na-arụ ọrụ na-agbadata akụkụ ụfọdụ na-eme ka sulfate / glucuronide conjugates.

Ngwakọta nke pioglitazone hydroxide (metabolites M-II na M-IV) na keto-derivative pioglitazone (metabolite M-III) na-egosipụta ọrụ ọgwụ. Na usoro nke metabolism nke ịba ọcha n'anya nke ọgwụ, ọrụ bụ isi bụ nkewapụ iche nke cytochrome P450 - CYP3A4 na CYP2C8. Ruo obere obere, ọtụtụ isoenzymes ndị ọzọ na-etinyekwa aka na metabolism nke ọgwụ ahụ, ọkachasị gụnyere extrahepatic isoenzyme CYP1A1.

N'ihe banyere Pioglar kwa ụbọchị na plasma, a na-ebute mkpụkọ pioglitazone (pioglitazone na metabolites na-arụ ọrụ) mgbe awa 24 gachara. Ọnọdụ ịta ahụhụ (C_ss) na plasma nke ngụkọta pioglitazone na pioglitazone ka achọpụtara ka ụbọchị asaa gachara.

A na-ewepụ ọgwụ ahụ tumadi na bile n'ụdị na-agbanweghi agbanwe na ụdị metabolites, kpochapụrụ ya na feces. 15-30% bụ nke ndị akụrụ ga - emegharị n'ụdị metabolites na conjugates ha. Nkera-ndu (T_½) pioglitazone na ngụkọta pioglitazone bụ 3-7 awa na 16 24 awa, karị.

Ihe ngosi maka ojiji

A na-atụ aro Pioglar maka iji ụdị ọrịa shuga mellitus nke 2 (dị ka ọgwụ monotherapy ma ọ bụ na njikọta metformin, insulin ma ọ bụ ọgwụ sulfonylurea n'ụdị ndị ahụ mgbe mmega ahụ, nri na monotherapy na otu n'ime ọgwụ antidiabetic dị n'elu anaghị anabata ịnweta njikwa glycemic zuru oke).

Ihe ngbanwe

• Ọkwa III - IV nkụda mmụọ, dị ka nhazi ọkwa nke New York Association of Cardiology (NYHA).
• ọrịa shuga ketoacidosis, ụdị shuga mellitus,
• oke ogo nke imeju, oke ọrụ nke enzymes imeju akari ihe kariri ihe kariri ugboro abuo (VGN),
• makroredituria sitere na amaghi,
• kansa eririka (gụnyere akụkọ ntolite)
• afọ ruo afọ 18
• ime na lactation,
• glucose-galactose malabsorption, ụkọ lactase, enweghị ụyọkọ galactose,
• ọgwụ mgbochi na akụkụ ọ bụla nke ọgwụ ahụ.

Ikwu (ekwesịrị iji ezigbo mkpachapụ mbadamba ụrọ)

• obi obara
• anaemia
• ọrịa edematous
• nsogbu nke imeju.

Pioglar, ntuziaka maka ojiji: usoro na usoro onunu ogwu

A na-ewere mbadamba Pioglar ugboro 1 kwa ụbọchị, n'agbanyeghị oge nri.

Mgbe ị na-eduzi monotherapy, a na-atụ aro ị theụ ọgwụ ahụ na ọgwụ nke 15-30 mg, dose kachasị kwa ụbọchị bụ 45 mg.

Na njikọta ọgwụgwọ na usoro metformin ma ọ bụ usoro sulfonylurea, a ga-eji pioglitazone mee ihe na mbido ọgwụ nke 15 ma ọ bụ 30 mg; ọ bụrụ na hypoglycemia emee, a ga-ebelata dose nke usoro metformin ma ọ bụ nkwado mmanụ.

Site na iji Pioglar jikọtara ya na insulin, ọgwụ pioglitazone mbụ kwa ụbọchị kwesịrị ịbụ 15-30 mg, ọgwụ insulin na-agbanwe agbanwe ma ọ bụ belata 10-25% ma ọ bụrụ na onye ọrịa ahụ na-akọ hypoglycemia ma ọ bụ plasma glucose concentrated na-ada ka ọkwa na-erughi 100 mg. / dl.

Nsonaazụ

• sistem iku ume: sinusitis, pharyngitis,
• sistemụ ụjọ na akwara: isi ọwụwa, dizzness, ehighị ụra nke ọma, hyposthesia, ọgba aghara a na-ahụ anya (ọ na - abụkarị na mmalite nke ọgwụgwọ ma a na - ejikọta ya na mgbanwe n'ọkwa glucose plasma, dị ka ọgwụ ndị ọzọ antidiabetic),
• sistem hematopoietic: anaemia,
• metabolism: hypoglycemia, ibu ibu,
• eriri afọ: flatulence,
• ọrịa akwara ma ọ bụ ajọ akwara: ọrịa kansa, ihe ịrịba ama nke mmepe nke nwere ike ịbụ ugboro ugboro ka ọ urinate, macrohematuria, mgbu n'oge urination, mgbu n'ime oghere afọ ma ọ bụ mpaghara lumbar (ọdịdị nke nkwarụ ndị a kwesịrị ịgwa dọkịta na-aga ya ngwa ngwa),
• usoro akwara: myalgia, arthralgia,
• plọgum ụlọ ọrụ: ịba ụba nke alanine aminotransferase (ALT) na creatine phosphokinase, mbelata ọkwa hemoglobin na mbelata ọbara hematocrit (ọ na-abụkarị obere elektrik, nwere ike ịbụ n'ihi mmụba nke olu plasma na-egosighi mmepe nke mmetụta ọgwụgwọ ọrịa akwara ọzọ).

Site na oge ọgwụgwọ ji karịa afọ 1, na 6-9% nke ikpe, enwere ike idepụta ọdịdị nke edema dị nro / na-agafeghị oke, na-anaghị achọ kagbuo Pioglar na ndị ọrịa.

N'oge usoro ọgwụgwọ, n'ọnọdụ ụfọdụ, omume nke ọdịda obi ga-ekwe omume.

Ntụziaka pụrụ iche

N'ime ndị ọrịa nwere usoro izizi na oge premenopausal na nguzogide insulin n'ihi ọgwụgwọ nke pioglitazone, enwere ike ịchọpụta mgbake ovulation. N'ihi mmụba dị ukwuu nke ndị ọrịa a na insulin ebe a na-ejighị ọgwụ mgbochi zuru oke, ohere nke ime nwere abawanye. Ọ bụrụ na ime dị n'oge ọgwụgwọ ma ọ bụ onye ọrịa ahụ na-eme atụmatụ ime, ekwesịrị ịkwụsị pioglitazone.

Dabere na nsonaazụ nke ọmụmụ ndị akọwapụtara, thiazolidinediones, gụnyere pioglitazone, mere ka mmụba na olu plasma na mmepe nke hypertrophy myocardial, n'ihi preload. N'ime ule ụlọ ọgwụ nke ndị ọrịa nwere klaasị III na nkụda obi obi (NYHA) esonyeghị, enweghị mmụba ugboro ugboro nke mmeghachi ike dị njọ site na sistemụ akwara obi, dabere na mmụba olu olu plasma (ọrịa obi na-adịghị ala ala).

Nsonaazụ nke nnwale ụlọ ọgwụ a na-achịkwa, yana data ọrịa na-efe efe, na-egosi ngbanwe egwu nke ọrịa kansa eriri afọ n'ọrịa ndị ọrịa mamịrị na-ewere pioglitazone n'ọtụtụ ọgwụ kwa ụbọchị ogologo oge. Agbanyeghị, ịnwe data ndị a anaghị ewepụ ohere nke ọrịa mamịrị na nwa oge ịgwọ ọgwụ. Ihe ndị a nwere ike metụtara ihe dị n’arụ kansa kansa: ịka nká, ịse anwụrụ (gụnyere n’oge gara aga), kemoterapi (gụnyere iji cyclophosphamide), ọgwụ radieshon nke akụkụ pelvic, na ụfọdụ ihe ọghọm n’ọrụ. Tupu mmalite nke usoro ọgwụgwọ, a chọrọ ọmụmụ macroscopic iji guzobe nnukwu macroredituria. Ọ dị mkpa ịgwa dọkịta ozugbo maka ihe ịrịba ama nke dysuria na mmepe ọ bụla nke mgbaàmà site na ọnya ọnya na / ma ọ bụ eriri afọ.

Site na ịrụ ọrụ ọrụ imeju

N'oge ọgwụgwọ, a na-atụ aro ka ị na-enyochakarị mkpokọta nke enzymes imeju na ọbara. N'ime ndị ọrịa niile, tupu ịmalite pioglitazone ịmalite ọgwụgwọ, ọnwa abụọ ọ bụla n'afọ mbụ nke ịnata Pioglar na oge kwa afọ nke usoro ọgwụgwọ, a chọrọ iji chọpụta ọkwa nke ALT. Ọ dịkwa mkpa ịtụle ọrụ nke imeju mgbe akara pụtara na nke ahụ nwere ike bụrụ ihe ịrịba ama nke ọdịda imeju, dịka mgbu afọ, ọgbụgbọ, vomiting, anorexia, adịghị ike, mmamịrị gbara ọchịchịrị. Ọ bụrụ na jaundice mere, kwụsị ị Pụ Pioglar.

Ojiji nke onye na - ahụ maka ọrịa hypoglycemic bụ contraindicated na ndị ọrịa nwere ọrịa imeju na - arụ ọrụ ma ọ bụ megide nzụlite nke ndị na - egosi ALT gafere ihe kariri 2.5 VGN.

Site na mmụba dị ntakịrị na ọkwa ALT (1-2.5 ugboro karịa nke nkịtị) tupu usoro ahụ ma ọ bụ n'oge ọgwụgwọ, achọrọ nyocha iji gosipụta ihe kpatara mmebi a. Na-amalite ma ọ bụ gaa n'ihu na ọgwụgwọ na Pioglar n'ihu ọnụọgụ na-abawanye na ọrụ nke enzymes imeju na-akpachapụ anya, na-eduzi nyocha ha ugboro ugboro.

N'okwu ahụ mgbe a na-achọpụta mmụba nke ọrụ hepatic transaminases site na ihe karịrị ugboro 2,5 ma e jiri ya tụnyere VGN, ọ dị mkpa iji nyochaa ọkwa nke enzymes mgbe niile, ruo mgbe ndị na-egosi na-agbadata na nkịtị ma ọ bụ na nke mbụ. Ọ bụrụ na ALT larịị gafere karịa ụkpụrụ ziri ezi karịa ihe karịrị ugboro 3 ma ọ bụ jaundice hụrụ, ekwesịrị ịhapụ pioglitazone.

Jiri na agadi

N'ime ndị agadi, tupu na n'oge ọgwụgwọ, n'ihi oke egwu nke nkụji, ọrịa nke ọrịa obi na ọrịa kansa eriri afọ na ndị ọrịa nke afọ a, nyocha nke ọma banyere uru na ọghọm nke ọgwụgwọ na Pioglar kwesịrị ime.

Mkparịta ụka ọgwụ ọjọọ

• ogwu mgbochi - a na-eme nchọpụta ọmụmụ ọgwụ nke jikọtara ọgwụ ndị a na pioglitazone, agbanyeghị, iji ọgwụ ndị ọzọ thiazolidinediones na njikọta ọnụ, nke gụnyere ethinyl estradiol / norethindrone, nyere aka belata ọkwa plasma nke ma homonụ ahụ site na 30%, nke nwere ike ibute mmetụta na-adịghị ike nchikota a gha akpachara anya
• warfarin, digoxin, metformin, glipizide - enweghị mgbanwe na ọgwụ ọgwụ nke pioglitazone,
• ketoconazole - a machibidoro metabolism nke pioglitazone n'ụzọ dị ukwuu, dịka ọmụmụ ọmụmụ vitro si dị, yana njikọ a ọ dị mkpa iji nlezianya nyochaa oke nke glucose ọbara,
• ọgwụ ọgwụ ndị ọzọ na-egbu egbu: ọ nweghị data banyere iji pioglitazone na njikọta nke atọ na ọgwụ ndị a.

Analogues nke Pioglar bụ: Astrozone, Diab-norm, Piouno, Amalvia, Diaglitazone, Piogli.

Pioglar nyocha

Dabere na nyocha, Pioglar bụ onye na-ahụ maka hypoglycemic nke ejiri maka ọgwụgwọ maka ụdị shuga mellitus nke 2, ma n'oge monotherapy yana yana ndị ọrụ hypoglycemic ndị ọzọ, gụnyere insulin. Ndị ọrịa rịbara ama na ọgwụ ahụ na - eme ka nchịkwa glucose dịkwuo elu ma na - eme ka nguzogide sel na - egbochi insulin, mana onye ọ bụla na - atụ aro iji Pioglar naanị dịka onye dọkịta gwara ya.

Ọdịmma nke Pioglar gụnyere ọnụnọ nke contraindications na mmepe nke nsonaazụ, ọkachasị mmụba nke ahụ, isi ọwụwa, flatulence.

Ọnụahịa Pioglar dị na ahịa ọgwụ

Enweghị ozi a pụrụ ịdabere na ya na ọnụahịa Pioglar, ebe ọ bụ na ereghị ọgwụ ahụ ugbu a na ahịa ọgwụ.

Mmụta: Universitylọ akwụkwọ Mahadum Medical Ahụike Moscow nke mbụ aha ya bụ I.M. Sechenov, ọpụrụiche "General Medicine".

A na - emejupụta ozi gbasara ọgwụ ahụ, enyere ya aka ka ọ nweta ihe ọ bụla, ọ naghị edochi ntuziaka gọọmentị. Medication medicationụ onwe gị ọgwụ dị ize ndụ nye ahụ ike!

Ọbara mmadụ "na-agabiga" n'ime arịa ndị nọ n'okpuru nrụgide dị ukwuu, ọ bụrụ na e mebiri iguzosi ike n'ezi ihe ya, ọ nwere ike gbaa 10 mita.

Ọkpụkpụ mmadụ siri ike karịa okpukpu anọ.

Ọ bụrụ na imeju gị kwụsịrị ịrụ ọrụ, ọnwụ ga-apụta n'ime otu ụbọchị.

A na-emefu ihe karịrị nde $ 500 kwa afọ na ọgwụ ndị nwere nsogbu nfụkasị naanị na United States. Still kwenyere na a ga-achọpụta ụzọ iji merie allergies n'ikpeazụ?

Enwere syndrom ọgwụ na-adọrọ mmasị dị ukwuu, dị ka ị inụ mmiri na-emetụta oke. N'ime afọ nke otu onye ọrịa na-arịa ọrịa a, achọpụtara ihe ndị ala ọzọ dị narị abụọ.

N'ime pasent 5 nke ndị ọrịa, Clomipramine antidepressant na-akpata mkpali.

N’inye nlele mgbe niile n’elu akwa anụ ahụ, ohere i nwere ibute ọrịa anụ ahụ na-abawanye site na 60%.

N'oge ịsụgharị, ahụ anyị na-akwụsị ịrụ ọrụ kpamkpam. Ọbụna obi na-akwụsị.

Ọ bụrụ na ị na-amụmụ ọnụ ọchị naanị ugboro abụọ n'ụbọchị, ịnwere ike belata ọbara mgbali ma belata ihe egwu nkụchi na ọnya afọ.

Dabere na ọnụ ọgụgụ, na ụbọchị Mọnde, ihe ize ndụ nke mmerụ azụ na-abawanye site na 25%, yana ihe ọghọm nke nkụchi obi - site na 33%. Kpachara anya.

Dabere na nyocha nke WHO, mkparịta ụka kwa ụbọchị na ekwentị na-eme ka ohere nke ịmalite ụbụrụ dị 40% nwee ohere.

Nwa nwoke onye Australia dị afọ 74, James Harrison ghọrọ onye na-enye ọbara n'ihe dị ka 1,000 ugboro. O nwere ụdị ọbara dị ụkọ, ọgwụ mgbochi nke enyere ụmụ amụrụ ọhụrụ aka na-arịa oke anaemia. N'ihi ya, onye Australia chebere ihe ruru ụmụaka nde abụọ.

Onye ọ bụla nwere ọ bụghị naanị mkpụrụ aka dị iche, kamakwa asụsụ.

Ọ na-emebu ikuku ahụ na-eme ka ahụ nwee ikuku oxygen. Agbanyeghị, echiche a kagburu. Ndị sayensị achọpụtala na mgbagharị, mmadụ na-eme ka ụbụrụ dị jụụ ma na-eme ka arụmọrụ ya ka mma.

E mepụtara akpa vibrator na narị afọ nke iri na itolu. Ọ rụrụ ọrụ na uzuoku ma na-bu n'obi na-agwọ ọrịa nwanyi.

Oge izizi nke okooko osisi na-abịa na njedebe, mana ahịhịa ga-anọchi ahịhịa site na mbido June, nke ga-akpaghasị ndị na-arịa ya.

Ọgwụ Farmacology

Selectively na-akpali nuklia gamma ndị na-anabata rụọ ọrụ site na peroxisome proliferator (gamma PPAR). Ọ na-emegharị mkpụrụ ndụ ihe nketa nke na-emetụta insulin ma na-etinye aka na nchịkwa nke ọkwa glucose na metabolism lipid na adipose, anụ ahụ akwara na imeju. Ọ naghị eme ka insulin too uto, ka o sina dị, ọ na-arụ ọrụ naanị mgbe echekwara ọrụ insulin-synthetic nke pancreas. Na-ebelata insulin iguzogide akwara anụ ahụ na imeju, na-abawanye oriri nke glucose na-adabere, belata mmepụta nke glucose site na imeju, na-ebelata ọkwa nke glucose, insulin na haemoglobin glucose dị n'ọbara. N'ime ndị ọrịa nwere metabolism ike, ọ na-ebelata triglycerides ma na-abawanye HDL na-agbanweghị LDL na cholesterol dum.

N'ime ihe omumu nyocha, o nweghi uto carcinogenic na mutagenic. Mgbe etinyere ụmụ oke na ụmụ oke ruru 40 mg / kg / ụbọchị, pioglitazone (ihe ruru ugboro 9 karịa nke MPDC, n'okwu nke 1 m 2 nke elu ahụ), enweghị mmetụta ọ bụla na ọmụmụ.

Achọpụtara n'ọbara 30 min mgbe nchịkwa ọnụ gasịrị, C_max na-enweta mgbe awa 2. A na-eri nri na - eme ka a ghara ịnabata gị (C_max edechara mgbe awa 3-4 gachara), mana anaghị emetụta ntoju ya. Ọ na - egbochi protein protein plasma, ọkachasị na albumin, site na ihe karịrị 99%. Ogo nke nkesa bụ 0.63 l / n'arọ. Nnukwu ọbara dị na ọbara na-adịgide ruo awa 24 mgbe ọ gbasịrị otu ọgwụ. Ndi_1/2 bụ awa 3-7 (pioglitazone) na awa 16–24 (metabolites). A na-emegharị ya na imeju na ntinye cytochrome P450 na ntinye nke metabolites abụọ na-arụ ọrụ, na-emeju glucose na sulfuric acid akụkụ ụfọdụ. Emere ya ka ọ bụrụ ihe na-agbanweghi agbanwe yana n'ụdị metabolites, sitere na ahụ na ahụ fits na mmamịrị (15-30%). Mkpuchi ala bụ 5-7 l / h.

Mmekorita

Ngwakọta nke sulfonamides, metformin na insulin potentiate (ibe ha) hypoglycemia. Ikekwe mmebi nke ọgwụ mgbochi afọ.

Emebeghị nnyocha Pharmacokinetic maka ojiji ọgwụ pioglitazone na ọgwụ mgbochi ọnụ. Ojiji nke thiazolidinediones yana mgbochi ogwu a na -eche nke nwere ethinyl estradiol ma ọ bụ norethindrone sochiri 30% na ntinye uche nke homonụ abụọ na plasma, nke a nwere ike ibute mbelata nke ukwuu na ọgwụ mgbochi. Ya mere, ekwesịrị ịkpachara anya na ojiji ejikọtara pioglitazone na ọgwụ mgbochi.

Mmekorita ya na CYP2C8 Inductor

Ndị na-eme CYP2C8 isoenzyme nke cytochrome P450 (dịka ọmụmaatụ rifampicin) nwere ike belata pioglitazone AUC nke ọma. Yabụ, na mbido ma ọ bụ nchupu ọgwụgwọ na CYP2C8 inducers, idozi dose pioglitazone nwere ike ịdị mkpa.

Ihe akpachara anya maka Pioglitazone

N'iji nlezianya, ndị ọrịa nwere edema na mmụba dị elu na ọkwa nke enzymes imeju. Mmepe nke hypoglycemia n'oge ọgwụgwọ ngwakọta na-achọ mbelata dose nke sulfonamides conulin ma ọ bụ insulin. Na-emegide nzụlite nke akụrụ gbasara akwara, idozigharị ọgwụ adịghị achọrọ. Ọ bụrụ na jaundice mere, a na-akwụsị ọgwụgwọ. N'ime ndị ọrịa nwere usoro izizi na oge ịmụgharị, nnabata nwere ike ibute oshi ma mụbaa ihe ịtụrụ ime (ihe mgbochi zuru oke dị mkpa).

Ewu nke ibute ọrịa kansa.

Ojiji nke pioglitazone maka ihe karịrị afọ 1 nwere ike jikọtara ya na oke ihe ibute ọrịa kansa ime.

Mgbe ị na-edepụta pioglitazone, ndị ọrịa kwesịrị iburu n'uche ihe ize ndụ nke ịmalite ọrịa cancer eriri afọ ma zere idenye ya ndị ọrịa kansa eriri afọ, gụnyere n'ime akụkọ ezinụlọ.
Ihe omuma nke nchekwa a maka pioglitazone sitere na nsonaazụ nke omumu ihe omumu abuo n’ileputara ndi oria kariri iri ario ya na oria di omimi banyere oria di mellitus.
N'ime ọmụmụ afọ iri nke nlere anya (Jenụwarị 1997 - Eprel 2008) na USA, etinyere ihe karịrị puku ndị ọrịa 193,000. Nnyocha dị n'etiti nyocha nke data sitere na ọmụmụ a gosipụtara na afọ, okike, ị smokingụ sịga, ị drugsụ ọgwụ ndị ọzọ maka ọrịa shuga na ihe ndị ọzọ n'ozuzu enweghị mmetụta dị ukwuu nke ịbawanye ọrịa cancer eriri afọ na ndị ọrịa na-ewere pioglitazone ma e jiri ya tụnyere ndị ọrịa na-adịtụbeghị etinyere (odidi ọdịmma OR = 1.2, 95% ntụkwasị obi etiti oge CI = 0.9-1.5). Agbanyeghị, ọgwụgwọ ogologo oge na pioglitazone (ihe karịrị ọnwa iri na abụọ) ka ejikọtara 40% ohere nke ibute ọrịa kansa eriri afọ (os = 1.4, 95% CI = 1.03-2.0).
Nsonaazụ nke ọmụmụ atụgharịrị azụ na-eme na France (2006-2009), nke gụnyere ihe dịka nde mmadụ 1.5 nde na-arịa ọrịa shuga, gosipụtara mmụba dị ukwuu na ọnya ọrịa kansa nwere ọnya pumglitazone karịa 28 mg (OS = 1.75, 95) % CI = 1.22-2.5) na mgbe ewerere ihe karịrị afọ 1 (OS = 1.34, 95% CI = 1.02-1.75), Ọzọkwa, ụmụ nwoke nwere ihe egwu dị elu karịa ụmụ nwanyị (OS = 1.28, 95% CI = 1.09-1.51).
Dabere na data sitere na ọmụmụ ndị a, a kwụsịrị iji pioglitazone na France, na Germany ka a tụrụ aro ka ịmalite ịmalite ọgwụgwọ pioglitazone na ndị ọrịa ọhụrụ.
Ekwesịrị ịgwa ndị ọrịa ndụmọdụ ọ bụla maka ihe mgbaàmà kansa kansa, dịka hematuria, urination, mgbu n'oge urination, mgbu na azụ ma ọ bụ ala ala.

Nkwadebe nke glitazone nke oge a

N'ime ọgwụ niile dị n'ahịa, ọ bụ naanị pioglitazone (Aktos, Diab-norm, Pioglar) na rosiglitazone (Roglit) ka erere ugbu a.

Ewepụrụ ọgwụ ndị ọzọ n'ihi nsonaazụ ndị ọzọ nke ọgwụgwọ.

Nkwadebe nke Thiazolidinedione

Troglitazone (Rezulin) bụ ọgwụ nke ọgbọ mbụ nke otu a. Akpọtara ya site na ire ya, n'ihi na o gosipụtara mmetụta ya na imeju na-adịghị mma.

Rosiglitazone (Avandia) bu ogwu nke umu ato. A kwụsịrị iji ya na 2010 (machibidoro ya na European Union) mgbe egosiri na ọ na-abawanye n'ihe ize ndụ nke ọrịa obi.

Usoro nke pioglitazone

Ihe omume nke pioglitazone bụ ijikọ na onye pụrụ iche PPAR-gamma receptor, nke dị na akwara sel. Ya mere, ọgwụ ahụ na-emetụta ọrụ nke mkpụrụ ndụ metụtara nhazi nke glucose. Imeju, n'okpuru ike ya, na-emepụta ya obere obere. N'otu oge, anụ ahụ na insulin na-abawanye.

Nke a bụ eziokwu maka abụba, akwara na akwara akwara. Ọzọkwa, enwere mbelata ọkwa glucose plasma na-ebu ọnụ na mmezu nke ịba uru glucose postprandial.

Mmetụta ntinye

Na mgbakwunye, achọpụtala na ọgwụ ahụ nwere mmetụta ndị ọzọ bara uru:

• E wedata ọbara mgbali elu
• Na - emetụta ọkwa nke cholesterol (na - eme ka ọnụnọ nke 'cholesterol dị mma'), ya bụ, HDL, ọ naghịkwa abawanye "cholesterol ọjọọ" - LDL),
• Ọ na-egbochi guzobe na uto nke atherosclerosis,
• Na-ebelata ihe ize ndụ nke ọrịa obi (dịka ọmụmaatụ, nkụchi obi, ọrịa strok).

Edere onye pioglitazone edere

Enwere ike iji Pioglitazone dịka otu ọgwụ, i.e. monotherapy. Ọzọkwa, ọ bụrụ na ị nwere ụdị ọrịa shuga mellitus nke 2, mgbanwe gị na ndụ gị anaghị enye nsonaazụ a tụrụ anya ya na enwere ọgwụ mgbochi na metformin, nnabata ya adịghị mma yana nsonaazụ ndị ọ ga-ekwe omume

Ojiji nke pioglitazone ga - ekwe omume na ọgwụ ndị ọzọ na - egbochi ọgwụ (dịka ọmụmaatụ, acarbose) na metformin ma ọ bụrụ na omume ndị ọzọ ewetaghị ihe ịga nke ọma.

A nwekwara ike iji insiolzazone mee insulin, ọkachasị ndị mmadụ mebiri ihe metformin n'ụzọ anụ arụ ha.

Otu esi ewere pioglitazone

Ekwesịrị ị Theụ ọgwụ a otu ugboro n’ụbọchị, ọnụ, n’oge a kapịrị ọnụ. Enwere ike ịme nke a tupu nri ma mgbe emesịrị nri, n'ihi na nri anaghị emetụta mwepu nke ọgwụ. Ọtụtụ mgbe, usoro ọgwụgwọ na-amalite site na obere ọgwụ. N'ọnọdụ ebe mmetụta ọgwụgwọ adịghị afọ ojuju, enwere ike ịbawanye nwayọ.

A na-achọpụta ịdị irè nke ọgwụ ahụ n'ọnọdụ ebe ọ dị mkpa iji gwọọ ụdị shuga 2, mana enweghị ike iji metformin mee ihe, a naghị anabata monotherapy na otu ọgwụ.

Na mgbakwunye na eziokwu ahụ bụ na pioglitazone na-ebelata glycemia postprandial, glucose plasma ma mee ka ahụ glycated glucose, ọ na-enwekwu mmetụta dị mma na ọbara mgbali na cholesterol ọbara. Na mgbakwunye, ọ naghị akpata nhụjuanya.

Nsonaazụ

Mmetụta ndị nwere ike ibute na ọgwụ pioglitazone gụnyere:

• Mmụba mmiri n'ime ahụ (ọkachasị mgbe eji insulin)
• Mmụba nke adịghị ike ọkpụkpụ, nke a juputara na mmerụ ahụ na-abawanye,
• Ọrịa na-efe efe ugboro ugboro
• Iwetara uru.
• Nsogbu ụra.
• Ọrịa imeju.

Theụ ọgwụ ahụ nwere ike ịbawanye n'ihe ize ndụ nke edema ede (ihe mgbaàmà mbụ nwere ike ịbụ nbibi nke visual acuity, nke ekwesịrị ịgwa dọkịta ophthalmologist ngwa ngwa) yana ihe ize ndụ nke ịmalite ọrịa kansa.

Ọgwụ a anaghị akpata hypoglycemia, kama ọ na-abawanye ihe ọghọm nke ịdaba mgbe ejiri ọgwụ ndị ewepụtara na insulin ma ọ bụ sulfonylurea.

Usoro onunu ogwu na nhazi

Pioglitazone (Aktos, Diab-norm, Pioglar) ewere ọnụ, oge 1 kwa ụbọchị, n'agbanyeghị nri nri. Ọgwụ nke mbụ bụ 15-30 mg, dose kachasị ụbọchị kwa ụbọchị bụ 45 mg, yana oke kachasị na njikọta ọgwụ bụ 30 mg / ụbọchị.

Rosiglitazone (Avandia, Roglite) ewere ọnụ 1-2 ugboro n'ụbọchị, n'agbanyeghị nri. Ọgwụ izizi bụ 4 mg / ụbọchị, otu kachasị kwa ụbọchị bụ 8 mg, yana oke kachasị na usoro ọgwụgwọ bụ 4 mg / ụbọchị.

Ntuziaka maka iji ọgwụ ahụ

A na-egosi nchịkwa nke ọgwụ naanị mgbe ọ gbasachara dọkịta na-aga ya, onye depụtara usoro ị correctụ ọgwụ ziri ezi, na-eburu n'uche njirimara onye ọrịa ahụ. N'ihe banyere iji Pioglitazone mee ihe, a ga-eji nlezianya mụọ ntuziaka maka iji zere nsogbu ọ bụla.

A na-egosi ọgwụ maka iji ya ma ọ bụrụ na usoro ọgwụgwọ mbụ sitere na 15 ruo 30 mg, yana kachasị (kwa ụbọchị) bụ 45 mg. Ọ bụrụ na ijikọta ihe ahụ na ọgwụ ndị ọzọ, dose ahụ ekwesịghị ịkarị 30 mg. A na-egosi Pioglitazone maka otu ugboro kwa ụbọchị.

N'oge usoro ọgwụgwọ, ịkwesịrị ịnọgide na-agbaso nri na mmega ahụ. Ọ dị ezigbo mkpa ịlele ọkwa haemoglobin dị n'ọbara.

E gosipụtara Pioglitazone site na nlekọta pụrụ iche maka ndị ọrịa nwere ọria, imeju nwere ụba enzyme. Site na mmepe nke hypoglycemia n'oge ọgwụgwọ ngwakọta chọrọ mbelata usoro nke insulin ma ọ bụ sulfonamides. Ọ bụrụ na onye ọrịa nwere ọrịa jaundice, enwere ike ịgbatị mmetụta na-adịghị mma n'ahụ ahụ, yabụ a ga-akwụsị ọgwụgwọ. Ọrịa nwere ọrịa ọgbụgba ọbara n'oge ọrịa premenopausal nọ n'ihe ize ndụ nke ime, yabụ a ga-eji ọgwụ mgbochi.

Ọgwụ ọgwụ dị iche iche eji na-arịa ọrịa shuga adịbeghị naanị insulin.

Pharmacology taa na-enye otutu uzo iji nyere aka belata shuga na oria nke abuo. A na - arụ ọrụ akụkụ dị mkpa n'ime ha artificially, dịka Pioglitazone (Pioglitazone).

Ngwakọta, ụdị ntọhapụ

Ọgwụ a na-ere ire n'ime igbe kaadi atọ ma ọ bụ 10, na-enwe mbadamba osisi iri abụọ nke agba gburugburu na agba ọcha. Ngalaba nọ n'ọrụ nwere ike ịdị na ha na mkpokọta nke 15, 30 ma ọ bụ 45 mg.

Ntọala isi ọgwụ ahụ bụ pioglitazone hydrochloride, nke na-ebelata ịdị nso nke imeju na anụ ahụ na-arụ ọrụ na homonụ, n'ihi nsonso nke glucose na-abawanye, ihe mmepụta ya na imeju na-ebelata.

Na mgbakwunye na nke bụ isi, mbadamba nkume nwere ihe ndị ọzọ:

• lactose monohydrate,
• stereta magnesium,
• hydroxypropyl cellulose,
• calcium carboxymethyl cellulose.

Omume ọgwụ

Pioglitazone na-ezo aka na ọnụnọ hypoglycemic nke sitere na thiazolidindine. Ihe ahụ na-etinye aka na nchịkwa nke glucose ọbara na metabolism metabolism. Mbelata nguzogide anụ ahụ na imeju na insulin, ọ na - ebute mmụba na mmefu nke glucose na - emetụta insulin na mbelata ume ya na umeji.

Agbanyeghị, ọ naghị ekpughe mmụba ndị ọzọ nke mkpụrụ ndụ nke pancreas, nke na-azọpụta ha pụọ ​​ịka nká ngwa ngwa. Mmetụta nke ọgwụ dị n'ọrịa shuga nke 2 na-eduga n'ọdịda ọbara glucose na haemoglobin glycosylated. Enwere ike iji ngwaahịa a naanị ma ọ bụ jikọta ya na ọgwụ ndị ọzọ na-ebelata shuga.

Ojiji nke ọgwụ ahụ na-enyere aka ịhazi metabolism lipid, na-eduga n'ịbelata ọkwa TG na mmụba na HDL na-enweghị emetụta cholesterol na LDL dum.

Ihe ngosi na contraindications

A na-atụ aro Pioglitazone dị ka ụzọ isi na-achịkwa ụdị ọrịa shuga 2. Enwere ike iji ya mee ihe dị ka otu ọgwụ, n'ihi na a na-enyekarị ya ndị ọrịa shuga bụ ndị buru oke ibu ma ọ bụ ndị metụtara Metformin.

Dịkwuo ike, a na-eji ọgwụ ahụ eme ihe n'ọgwụgwọ na usoro ndị a:

• Nchikota abuo na metformin ma obu ogwu sulfonylurea,
• Nchikota onu ogugu ato nke ogwu ojoo

Dị ka contraindications bụ:

• oke uche na akụkụ ọ bụla nke ọgwụ,
• akụkọ banyere ọrịa obi
• nnukwu ọnya afọ,
• ụdị shuga 1
• ọrịa mamịrị ketoacidosis,
• ọnụnọ kansa
• ọnụnọ herosuria macroscopic nke mmalite esighị n'aka.

N'okwu ndị a, a dochie ọgwụ ahụ na analogues nwere usoro mejupụtara na usoro dịgasị iche.

Ndị Ọrịa na Nduzi Pụrụ Iche

Maka ndị okenye, enweghị usoro ịchọrọ iche. Ọ na-amalite site na nke kacha nta, jiri nwayọọ nwayọọ na-abawanye.

N’oge ime ime, a naghị anabata ọgwụ maka iji ya eme ihe, ọ bụghị ihe omuma ya na nwa ebu n’ucheghi nke ọma, n’ihi ya, o siri ike ịkọ ihe ga-esi na ya pụta. N’oge ị na-agba akwụkwọ, ọ bụrụ na nwanyị kwesịrị iji ọgwụ a, o kwesịrị ịjụ inye nwa ahụ.

Ndị ọrịa nwere ọrịa obi na akwara ọbara na-eji ntakịrị opekempe, ebe ọ dị mkpa iji nyochaa ọnọdụ nke akụkụ ahụ nsogbu n'oge nchịkwa Pioglitazone.

Pnweta Pioglitazone nwere ike iwelite ohere nke ịmalite ọrịa kansa eriri afọ site na pasent 0.06, nke dọkịta kwesịrị ịdọ onye ọrịa aka na ntị ma tụọ ibelata ihe ndị ọzọ dị ize ndụ.

Maka ndị ọrịa nwere nnukwu umeji akwara, a na-egbochi ọgwụ ahụ, yana n'ịdị nwayọ, were iji nlezianya kwere omume. N'okwu a, ọ dị mkpa ịchịkwa ọkwa nke enzymes imeju, ọ bụrụ na ha gafere iwu ahụ ugboro atọ, a na-akagbu ọgwụ ahụ.

Vidio banyere nsonaazụ nke ọgwụ shuga n’ahụ:

Nkwadebe nke mmemme yiri ya

A na-egosi Plọglitazone analogs n'ahịa ahụ nwere ọtụtụ ihe dị iche iche.

Ngwaọrụ nwere otu ihe mejupụtara gụnyere:

• Indian ọgwụ Pioglar,
• Ihe atụ nke Russian nke Diaglitazone, Astrozone, Diab-Norm,
• Mbadamba akwụkwọ nke Irish,
• Croatian usọbọ Amalvia,
• Pioglite
• Piouno na ndị ọzọ.

Ọgwụ ndị a niile dị na otu nke glitazone, nke na-agụnye troglitazone na rosiglitazone, nke nwere usoro ọrụ yiri ya, mana dị iche na usoro kemịkalụ, yabụ enwere ike iji ya mgbe anụ ahụ jụrụ pioglitazone. Ha nwekwara uru na ọghọm nke ha, nke enwere ike ịchọta na ntuziaka maka ọgwụ.

Ọzọkwa, analogues nwere usoro dị iche iche nwere ike ịrụ ọrụ dị ka analogues: Glucofage, Siofor, Bagomet, NovoFormin.

Ọ dị mma ịmara na nyocha nke ndị ọrịa ji Pioglitazone na mkpụrụ ndụ ihe ọmụmụ ya dịtụ iche. Yabụ, n'ihe metụtara ọgwụ n’onwe ya, ndị ọrịa na-azaghachikarị n’ụzọ dị mma, na-anata ntakịrị nsogbu nke mmetụta ndị ọ na-enwe.

Ceptionmata analogues na-ebutekarị nsonaazụ na-adịghị mma, dị ka oke ibu, edema, mbelata hemoglobin.

Dika omume gosiputara, ogwu a n’eeduba n’ebe shuga ma nwekwa ike iji ya rụọ ọrụ nke ọma n’inye ụdị ọrịa shuga ụdị 2. Agbanyeghị, ọ dị mkpa ịhọrọ ọgwụ na usoro ịchọrọ ọfụma.

Ahịa ahịa

Ebe ọ bụ na enwere ike imepụta ngwá ọrụ ahụ n'okpuru aha dị iche iche, dabere na onye nrụpụta, ọnụ ahịa ya dị iche iche. Buyzụta Pioglitazone na ụlọ ọgwụ ụlọ na ụdị dị ọcha bụ nsogbu, a na-etinyere ya n'ụdị ọgwụ ọjọọ na aha ndị ọzọ.Achọtara ya n'okpuru aha Pioglitazone Asset, ọnụ ahịa nke na usoro ogwu nke 45 mg sitere na puku abụọ rubles.

Pioglar ahụ ga-eri 600 na ruble ole na ole maka mbadamba iri atọ nke iji ọgwụ nke 15 mg na obere ọnụ karịa otu puku maka otu ego ya na iji ọgwụ nke 30 mg.

Akgwọ nke Aktos, na ntuziaka nke edepụtara otu ihe eji arụ ọrụ, dị nso site na 800 na 3000 rubles.

Amalvia ga-eri 900 rubles maka usoro nke 30 mg, na Diaglitazone - site na 300 rubles maka usoro onunu 15 mg.

Ọganihu nke ọgwụ ugbu a na-eme ka o kwe omume inweta nsonaazụ kachasị mma na ngalaba nlekota na imezi ọkwa shuga dị n'ọbara. Ojiji nke ọgwụ ọhụụ nwere ike nweta nke a ngwa ngwa ma rụọ ọrụ nke ọma, ọ bụ ezie na ha enweghị enweghị ndọghachi azụ, nke ị kwesịrị ịma banyere tupu ịmalite ị .ụ ọgwụ.