Acarbose ea lefu la tsoekere
1S- (1alpha, 4alpha, 5beta, 6alpha) -0-4,6-dideoxy-4-4,5,6-Trihydroxy-3- (hydroxymethyl) -2-cyclohexen-1-ylamino-alpha-D-glucopyranosyl- (1-4) -0-alpha-D-glucopyranosyl- (1-4) -D-glucose kapa (2R, 3R, 4R, 5S, 6R) -5- (2R, 3R, 4R, 5S, 6R) - 5- (2R, 3R, 4S, 5S, 6R) -3,4-dihydroxy-6-methyl- 5- (1S, 4R, 5S, 6S) - 4,5,6-trihydroxy-3- (hydroxymethyl) cyclohex-2-en-1-ylaminooxan-2-yloxy-3,4-dihydroxy-6- (hydroxymethyl) oxan-2-yloxy-6- (hydroxymethyl) oxan-2,3,4-triol (IUPAC).
Lisebelisoa tsa likhemikhale
K'habohaedreite e tsoang sehlopheng oligosaccharides Acarbose ke phofo, e tšoeu kapa e tšoeu e nang le moriti leha e le ofe, o qhibilihang haholo ka metsing. Lintho li fumanoa ho Actinoplanes utahensis sebelisa belisoa. Boima ba molek'hule ea motsoako oa lik'hemik'hale ke ligrama tse 645.6 ka karolelano. Setlhare se lokolloa ka mokhoa oa matlapa, ka tekanyetso ea 50 kapa 100 mg.
Pharmacodynamics le pharmacokinetics
Sesebelisoa se pepesa oligo le polysaccharides ha metsi a arabela ka ho qobella ho thibela pancreatic alpha amylase le mala li-alpha glucosidase tsa membrane. Tlas'a tšusumetso ea acarbose, lumen ea mala a manyane ea senyeha di, oligo le trisaccharides ho tse fapaneng monosaccharides le tsoekere. Botebo ba sebopeho le ho monya ha tsoekere ka mpeng ea fokotseha, boemo ba letsatsi le letsatsi ba glucose maling boa tsitsa. Moriana ha o hlohlelle kholo insulin ebile ha e lebise ho hypoglycemia.
Ntho ha e mutagenic, ha e ame tsoalo le bokhoni ba ho ikatisa ka botlalo.
Ka tsamaiso e hlophisehileng ea lithethefatsi ho bakuli ba nang le ts'oaetso ea glucose e kotsi, kotsi ea mofuta oa lefu la tsoekere, myocardial infarction le lefu la pelo.
Acarbose e na le tekanyo e tlase ea ho ruruha hoa systemic, e ka bang 35%. The bioavailability ea tatellano ea 1-2%. Khokahano e phahameng ea ntho ka boeona e bonoa maling maling ka mor'a hora ea tsamaiso, le li-metabolites tsa eona - kamora lihora tse 14 - ka letsatsi.
Ho batho ba nang le bothata ba ho phekoloa ke lipholisa, maemo a phahameng a khatello a eketseha ho fihla ho makhetlo a 5, ho bakuli ba tsofetseng pontšo ena e eketseha ka makhetlo a 1.5.
Setlhare se na le motsoako 'meleng oa tšilo ea lijo le ho kenya letsoho ha libaktheria tsa ka mpeng le li-enzyme tse amanang le tšilo ea lijo, tse ka bang 13 metabolites li le teng Acarbose. Tsena ke tse tlisoang haholo 4-methylpyrogallol. Lintho tse sa fetoloang (hoo e ka bang halofo ea lethal) li tšeloa ka har'a maro ka nako ea lihora tse 96. Hoo e ka bang 35% ea moriana o hloekisoa ka sebopeho sa metabolites ka liphio. Karolo ea halofo ea bophelo ke lihora tse 4 (karolo ea phepelo) le lihora tse 10 (karolo ea excretion).
Contraindication
Setlhare se kopantsoe le ho nka:
- ho allergy ho acarbose
- bakuli ba nang lefu la tsoekere la ketoacidosis, cirrhosis,
- mafu a sa foleng le a hlobaetsang le ho ruruha ha mmele, a tsamaeang le mafu a ho hlohlona le ho monya,
- kula le Remheld's syndrome,
- basali ba nyehlisang
- ka li-pathologies tsa tšilo ea lijo, li tsamaisana le ulcerative colitis, botlaelaho kenella ka mpeng (ho kenyeletsa le le leng),
- Bakuli ba nang le litšoelesa le mala a ka mpeng, hernias e kholo,
- a sa foleng ho hloleha ha rems,
- nakong ea ea boimana.
Tlhokomeliso e bontšoa ha u nka Acarbose:
- bakuli ba nang le tšoaetso, likotsi, ka mor'a ho buuoa,
- khona ho feberu,
- batho ba ka tlase ho lilemo tse 18.
Litlamorao
Lintho tse mpe tse atisang ho hlaha tse tsoang pampiring ea mpa:
- tlhahiso e eketsehileng ea khase, lets'ollobohloko bo ka mpeng, ho hlatsa, ho sithabela,
- ho nyekeloa ke pelo, litšitiso tse felletseng kapa tse itseng,
- jaundice, mosebetsi o eketsehileng oa li-enzyme tsa sebete, hepatitis.
E boetse e hlokometsoe: ho ruruha, thrombocytopenia, urticariamakhopho a letlalo, erythema.
Acarbose, litaelo tsa tšebeliso (Mokhoa le litekanyetso)
Matlapa a fanoa ka molomo, metsotso e 20 pele ho lijo kapa hora ka mor'a lijo.
Mehatong ea pele ea kalafo, 50 mg ea moriana e sebelisoa makhetlo a 3 ka letsatsi, ebe ka nako eo litekanyetso li eketsoa ho gramu ea 0-0-0,2, ho latela mamello.
Ka karolelano, litekanyetso tsa bakuli tse boima bo ka tlase ho 60 kg ke 50 mg, ho feta 60 kg ke 300 mg ka letsatsi. Sekhahla se phahameng sa letsatsi le letsatsi ke ligrama tse 0,6.
Bakeng sa thibelo, sethethefatsi se laetsoe ho 50 mg ka letsatsi, 'me butle-butle se eketsehe ho fihlela li-gram tse 0,1 ho feta likhoeli tse 3.
Tšebelisano
Phello ea hypoglycemic ea lithethefatsi e ntlafatsoa ke ketso ea tse tsoang ho tsona sulfonylureas, metformin, insulin.
Colestyramine, antacid le li-adsorbents tse sebetsang ka mpeng, li fokotsa katleho ea kalafo ka Acarbose.
Glucocorticosteroids, estrogenslihormone tsa qoqotho, li-diaztiti tsa thiazide, phenothiazines, phenytoinlithibela-pelehi tsa molomo nicotinic acid, isoniazid, adrenostimulants le lithethefatsi tse ling tse bakang hypoglycemia fokotsa haholo ts'ebetso ea moriana, ho fihlela ho bolaoa lefu la tsoekere.
Litaelo tse khethehileng
Nakong ea kalafo le moriana, ho hlokahala ho latela litlhahiso tsa ngaka, ho latela lijo. Lino le lijo tse nang le lik'habohaedreite le tsoekere li ka baka mathata a ka mpeng.
Nakong ea kalafo, ho khothalletsoa le ho laola maemo a tsoekere ea mali le moroto glycosylated hemoglobin le transaminase, haholoholo likhoeling tse 12 tsa pele tsa kalafo.
Ka keketseho ea lethal dose e fetang ligrama tse 0,3 ka letsatsi, ho tla fokola haholo hyperglycemia le likotsi tse eketsehileng hyperfermentemia.
Nakong ea kalafo ka sehlahisoa, ho lokela ho hopoloa hore tsoekere e tloaelehileng ea lijo e robeha butle mme ha e khone ho tlosa kapele hypoglycemia. Ho felisa boemo bona, ho khothalletsoa ho sebelisa tekanyetso e kholo tsoekere (Eseng sucrose), haholo-holo ka kotloloho.
Moriana, joalo ka molao, ha o fuoe bana ba ka tlase ho lilemo tse 18.
Litokisetso tse nang le (Analogs)
Litlhahlobo tsa moriana ho loana lefu la tsoekere haholo ntle. Litlamorao tse atileng ka ho fetisisa le tse tšoenyang ke khaello ea khase le mpeng. Litlhahlobo mabapi le Acarbose bakeng sa tahlehelo ea boima ba 'mele li ile tsa aroloa. Moriana ona o ne o loketse motho e mong, 'me e mong ka mor'a ho sebelisa lipilisi o qala ho sebelisa lipompong ka matla le ho lahleheloa ke taolo. Re lokela ho hlokomela hore nakong ea kalafo ho hlokahala ho latela mokhoa oa ho ja, ho seng joalo, katleho ea kalafo e fokotsehile haholo.
Theko ea Acarboza, ho reka
Theko ea matlapa a Glucobai e ka ba li-ruble tse 560 bakeng sa likotoana tse 30, ka litekanyetso tsa 100 mg.
Thuto: O qetile Kolecheng ea Rivne State Basic Medical College ka lengolo la degree. O fumane lengolo la univesithi ea Vinnitsa State Medical. M.I. Pirogov le internship e thehiloeng ho eona.
Phihlelo: Ho tloha ka 2003 ho fihlela ka 2013, o ile a sebetsa e le morekisi oa meriana le mookameli oa k'hemiste ea meriana. O ile a fuoa mangolo le likhetho bakeng sa lilemo tse ngata tsa mosebetsi o hlokometsoeng ka hloko. Lingoloa tse mabapi le lihlooho tsa bongaka li ile tsa phatlalatsoa likhatisong tsa lehae (likoranteng) le liphatlalatsong tse fapaneng tsa inthanete.
Leeto la nalane
Boiteko ba ho pholosa batho ho tloha “seoa se setle” bo entsoe lekholong la lilemo le fetileng.
Ke 'nete, ho ea ka lipalo, ka nako eo ho ne ho se na palo e joalo e khahlisang ea batho ba nang le lefu la tsoekere. Boloetse bona bo ile ba qala ho ata ka matla ha lishelefo tsa mabenkele a rona li qala ho khaoha lihlahisoa tsa boleng bo belaetsang, hobane Soviet GOSTs e hlakotsoe, mme maemo a macha a botekgeniki a ne a sa sitise moetsi ho liteko tsa bophelo ba rona.
Ho utloisisa hore bothata bo ka sehloohong ba lefu la tsoekere mellitus (DM) ke tlolo ea metabolism ea carbohydrate, bo-rasaense ba ile ba leka ho theha sethethefatsi sa lefats'e se lekang ts'ebeliso ea lik'habohaedreite, tse fanang ka motho ea moholo le halofo ea letsatsi la likhalori.
Ho joalo, kajeno ha ho motho ea atlehileng ho fihlela sepheo sena ntle le lijo tse tlase tsa carb, empa tšusumetso e eketsehileng ea mafura le carbohydrate metabolism e ke ke ea utloisa bakuli lefu la tsoekere, haholo hobane ba fokolang ba bona ba khona ho latela likeletso tsa endocrinologist.
Kamora ho bala lijo tsa letsatsi le letsatsi tsa batho bao e seng lefu la tsoekere:
- Monosaccharides (ka sebopeho sa fructose le tsoekere) - 25 g,
- Li-Disaccharides (sucrose) - 100g,
- Polysaccharides (joalo ka starch) - 150g.
Ho ka utloisisoa hore ho thibela tsoekere e ngata ho fanoa hamolemo mohatong oa pele oa metabolism, ka popelong, moo ba tla tsoa ka mokhoa oa bona oa pele.
Hobaneng ha motho a tsotella haholo starch? Karolo ea tlhaho ea α-amylase e na le amylose le amylopectin, 'me e ka robeha ho hlakoloa ho sebelisoa mathe le manyeme, a nang le enzymes tsa α-amylase. Li-disaccharides li kenella ka har'a glucose le fructose ka mpeng ka tlas'a tšusumetso ea li-glucosidase. Ke li-monosaccharides tsena tse kenang maling a mali ho tsoa mala.
Ho totobetse hore ho fokotseha ha tšebetso ea manyeme le mala ho tla liehisa ho amoheloa ha karolo ea lik'habohaedreite tse kenang 'meleng ka lijo. Lintho tse thibelang li-enzymes tsa saccharolytic, tse fumanehang limeleng tse ling (mohlala, ho stevia), li haola habonolo mme ha li fane ka litlamorao tse sa rateheng. Li-analogs li fumanoe ka li-buckwheat, rye, poone, legumes le peanuts. Ka bomalimabe, bokhoni ba bona bo ne bo sa lekana bakeng sa taolo ea glycemic ea lipalo tsa mali.
Li-substrates tsa Microbial li fumanoe li sebetsa hantle haholo, ho tloha moo li-inhibitors tse nang le sephetho se pharaletseng li fumanoeng: liprotheine, li-aminosaccharides, oligosaccharides, glycopolypeptides. Olisaccharide e tšepisang ka ho fetisisa e ne e le Acarbosum, e entsoe ka likokoana-hloko tse lenngoeng. Ka ho thibela li-glucosidase tse ka mpeng, e liehisa phetoho ea starch hore e be glucose.
Mehloli e meng ea eona e hlahisitsoe motheong oa ascarbose, empa ha e na matla a joalo a ntlafatsang.
Monyetla oa pharmacological
Meriana e thehiloeng ho Ascarbose:
- Fokotsa ho kenella ha lik'habohaedreite ka mala,
- Fokotsa postprandial (kamora ho ja, "prandial" - "lijo tsa motšehare") glycemia,
- Thibela hypoglycemia,
- Khetholla monyetla oa ho eketsoa ha insulin.
Ha o ja lijo tse nang le lik'habohaedreite tse ngata, phello ea hypoglycemic ea ascarbose e bonahala haholo.
Inhibitor e thusa ho loants'a botenya, e fokotsa takatso ea lijo le lijo tse matlafatsang tsa letsatsi le letsatsi, hape e fokotsa lera la mafura a visceral.
Ho tlatsetsa ho mafura, lijana tse nang le khalori e ngata haholo ho fokotsa ts'ebetso ea acarbose, hobane ts'ebetso ea eona e reretsoe ho tloaelehileng carbohydrate, ho fapana le metabolid ea lipid.
Acarbose ka mochine oa ts'ebetso o bapisoa le bokhoni ba fiber, likhoele tsa maiketsetso tse bopa hlama, li sa fumanehe bakeng sa tšilo ka li-enzyme. Phapang ke hore lithethefatsi li thibela bokhoni ba li-enzyme ka bobona. Joalo ka ho hloka botsitso ha lisele, lik'habohaedreite li "se khone ho kenella" bakeng sa lero la gastric mme li tsoe li sa fetohe, li eketsa bongata ba makhopho. Ho sena ho latela hore bokhoni ba inhibitor bo ka ntlafatsoa haeba lihlahisoa tse nang le likhoele tse kopaneng li sebelisoa ka ho tšoana. Mokhoa ona o sebetsa haholo ho theoleng boima ba 'mele.
Leha e na le thepa ea eona e thibelang, inhibitor ha e senye ts'ebetso e tloaelehileng ea mpa, hobane ha e ame ka kotloloho mosebetsi oa amylo-, proteino- le lipolytic oa lero la tšilo ea lijo.
Bokhoni ba sethethefatsi le bona bo itšetlehile ka tekanyetso: ka keketseho ea maemo, matšoao a hypoglycemic a phahame.
Litsebi tsa lefu la tsoekere tse nkang acarbose le lihlahisoa tsa lona li bontšitse litholoana tse ntle maemong a mang a bohlokoa:
- Triglycerol le k'holeseterole e theohileng maling,
- Ho fokotseha ha lipoprotein lipase mahloriso ho lisele tsa adipose.
Haeba inhibitor e kenngoa ka ho toba ka mpeng, e thibela ts'ebetso ea li-glucosidase. Lik'habohaedreite li chesoa nako e telele hoo karolo e kholo ea tsona e sa fetoloang. Sena se ama matšoao a glucometer ka tsela e ntle ka ho fetisisa: leha li eketseha, ha li bohlokoa joalo ntle le ho nka karolo ha acarbose. Mabapi le ts'ebetso, e ka bapisoa le Metformin e tsebahalang, e kopantsoeng le lefu la tsoekere le ho se sebetse hantle ha methapo.
Acarbose e boetse e laeloa mofuta oa pele oa lefu la tsoekere, kaha tšebeliso ea lona e fokotsa palo ea insulin e eketsehileng ka halofo.
Setlhare se tla thusa ho tloaetsa glycemia, empa phepo e hloka ho fetoloa bakeng sa eona, hobane khaello ea lik'habohaedreite e kotsi le ho feta.
Le maemong a tsoetseng pele, le lefu la tsoekere le lekantsoeng, ha insulin e tlatselletsa tsoekere, kamora 'nete ea kalafo ea acarbose, batho ba nang le lefu la tsoekere ba ile ba hlokomela ho fokotseha ha glucosuria (ho ba teng ha glucose moseneng).
E eketsa mamello ea lithethefatsi le tsoekere, empa ha se ntho e nkang 100% ea litlhare tsa mantlha bakeng sa kalafo ea lefu la tsoekere. E hlalositsoe e le litlatsetso tse ling tsa kalafo e kopaneng. Mohlala, acarbose e tla ntlafatsa phello ea sulfonylurea.
Motsoako ona o boetse o bontšoa bakeng sa batho ba kulang ba ke keng ba mamella insulin.
Ho bohlokoa hore mofuta ona oa inhibitor ha o na bokhoni ba carcinogenic, embryotoxic le mutagenic.
Setlhare ha se nke lehlakore mokhoeng oa ho silila, libaktheria le li-enzyme li thusa ho theha mefuta e 13 ea lintho. Acarbose e sa sebelisoeng e tsoa ka mala ka lihora tse 96.
Ho bontšoa mang le mang ea acarbose?
Anhibitor e reretsoe ho:
- Type 2 lefu la tsoekere
- Carbohydrate metabolism
- Mathata a Metabolic,
- Lefu la tsoekere
- Ho Nona Haholo
- Ho hloka mamello ea tsoekere e ngata,
- Tlokotsi ea glycemia e potlakileng,
- Lactate le lefu la tsoekere,
- Type 1 lefu la tsoekere.
Ts'ebeliso ea acarbose e tšoaetsitsoe ho:
- Cirrhosis ea sebete,
- Ketoacidosis,
Ho ruruha le liso tsa ka mpeng ea gastrointestinal,- Ulcerative colitis
- Tšitiso ea kahare,
- Lefu la tsoekere,
- Boimana, ho nyeka,
- Lilemo tsa bana.
Ho ruruha le liso tsa ka mpeng ea gastrointestinal,Ka hlokolosi, acarbose le lihlahisoa tsa eona li laetsoe kamora ho lemala, nakong ea mafu a tšoaetsanoang, kaha 'mele o fokolisitsoeng ha o na matla a lekaneng a ho fola. Ka bofokoli ba tsoekere kapa ho thibeloa ha eona, hypoglycemia kapa acetonemic syndrome e khonahala.
Litla-morao tse teng lia khoneha:
- Motsamao oa bowel
- Mathata a amanang le dyspeptic
- Keketseho e kholo ea li-transaminase,
- Phokotso ea Hematocrit
- Fokotsa litaba tsa livithamini le khalsiamo maling a,
- Ho ruruha, ho hlohlona, ho kulisa.
Ho ruruha ha Stool, bohloko ba ka mpeng le mathata a mang a ka mpeng le mala li ka etsahala ka lebaka la hore butle-butle ho kenngoa ha lik'habohaedreite ho etsa hore ba bang ba bona ba ipokelletse ka har'a tšilo ea lijo 'me ba teng nako e telele pele ba kena ka mpeng e kholo. Ho bokellana hamonate ho baka kholo ea libaktheria tse bakang ho ruruha, phahlo, le mathata a mang a dyspeptic.
Phello e ts'oanang e bonoa tlhahisong ea champagne, ha libaktheria tse nang le phepo ea baktheria e hlahisang tsoekere li siea litholoana tsa bophelo ba tsona bo hahelletsoe ka boqhetseke. Mohlomong, ka ho nahana ka setšoantšo sena, ba bangata ba ka be ba ile ba tlohela joala.
U ka khelosa sefefo se ka mpeng ka metronidazole, e boletsoeng ke ngaka ha e bapisoa le acarbose. Ho sebelisa k'habone le li-sorwts tse ling ho khutsisa microflora ea mala le tsona li na le matla a tšoanang.
E fokotsa katleho ea tsamaiso e tšoanang ea acarbose:
- Estrogen
- Moriana ea Hormone ea tšoelesa ea qoqotho.
- Lithibela-mafu tsa molomo
- Likhohlano tsa calcium
- Phenothiazines le meriana e meng.
Acarbose - litaelo tsa tšebeliso
Ho latela litaelo, litekanyetso li beoa ho latela boima ba mokuli. Haeba, mohlala, lefu la tsoekere la motho e moholo le na le boima ba 'mele ea 60 kg, lethal dose la 25-50 mg le lekane ho eena, ka khanya e kholo, 100 mg 3 r. / Letsatsi le laetsoe.Motsoako oa inhibitor o tlameha ho eketsoa ka mekhahlelo, e le hore 'mele o khone ho ikamahanya le maemo,' me a utloise bohloko ha a sebetsana le maemo.
Tšoaea moriana pele u ja kapa ka nako e tšoanang. E hlatsuoa ka mokelikeli o mong le o mong, haeba seneke se se na lik'habohaedreite, acarbose e ke ke ea nkuoa.
Haeba 'mele o amohela hampe lethalinyana le khethiloeng, le ka eketsoa ho 600 mg / ka letsatsi. mme e phahame le ho feta haeba bophelo bo botle bo lumella.
Inhibitor Analogs
Analogue e tummeng ka ho fetisisa ea acarbose ke Glucobay. Hypoglycemic agent e hlahisoa Jeremane. Fomu ea tokollo - litafole tse boima ba 50-100 mg, sephutheloana ka seng se na le likotoana tse 30 ho isa ho tse 100.
Ntle le sethethefatsi sa pele China le Europe, o ka reka generic e nang le lebitso la brand Glucobay, USA le England - Precose, Canada - Prandase. Bakeng sa batho ba nang le lefu la tsoekere le cuisine ea bochabela, lithethefatsi li sebetsa hantle, hape li tumme haholo Chaena, USA - ho fapana le moo, ts'ebeliso ea eona e lekantsoe ka lebaka la lets'ollo le bohlasoa.
Litlhahlobo mabapi le acarbose
Mabapi le moriana o nang le acarbose Glucobay, litekolo tsa ho theola boima ba 'mele li ngotsoe ka bongata. Setlhare ha se reretsoe ho theola boima ba 'mele, se fuoe batho ba lefu la tsoekere, hangata e le mofuta oa bobeli.
Kaha boholo ba rona re fumana matla ho lik'habohaedreite, sethethefatsi se molaong se hlile se thusa batho ba nang le lefu la tsoekere le ba fokotsehang 'meleng ho ja lijo ebile ha ba na litla-morao tse bobebe joalo ka hobane li ka nooa ka morero pele ho sekhechana sa khekhe kapa teko e' ngoe ea carbohydrate.
Ketso ea pharmacological
E na le phello ea hypoglycemic. Inhibitor e thibelang ts'ebetso ea li-enzyme tse hlatsoang lik'habohaedreite ho tsoekere e bonolo. Ho kenngoa ha lik'habohaedreite ka mpeng ho ea butle, boemo ba glucose boa tsitsa. Acarbose e loketse haholo ba kulang ke insulin kapa ba sa loketseng kalafo ea metformin ka lebaka la li-contraindication. Ha e na thepa ea carcinogenic, e sireletsehile 'meleng ho feta lithethefatsi tse ling tse ngata. E ama ho emisoa ha hypoglycemia kamora ho ja 'me ka kakaretso e fokotsa menyetla ea kholo ea eona. E fokotsa takatso ea lijo, e thusa ho boloka boima ba 'mele bo tloaelehileng, hape e thibela nts'etsopele ea kholo ea insulin. Haholo-holo litlamorao tse hlakileng tsa acarbose ha li nkuoa ka lihlahisoa tse nang le carb e phahameng. Ho feta moo, khoholeho ea cholesterol le triglycerides maling e ea fokotseha, le lipoprotein lipase ho lisele tsa adipose.
Acarbose e sebetsa joang? Joalo ka fiber, e etsa hore lik'habohaedreite li se ke tsa fumaneha ho lero la gastric le ketso ea li-enzyme tse li lihelang li-monosaccharides. Ka lebaka leo, li qheleloa ka har'a mantle, empa mosebetsi oa mpa ha o khathatsehe.
Mofumahali
E sebetsa ka mpeng ea gastrointestinal, e kenngoa ka mokhoa oa metabolites. Khokahano e kholo e bonoa kamora hora. E kenngoa ka har'a tšilo ea lijo ka boeona, e kenyellelitsoe mantleng ka lihora tse 96, hape le ka liphio ka mokhoa oa metabolites (34%).
- Lefu la tsoekere la mefuta e 'meli ea phekolo e kopaneng,
- Lefu la tsoekere
- Ho nona haholo joalo ka lefu la lefu la tsoekere,
- Khanyetso ea insulin kapa allergy.
Litaelo tsa ho sebelisoa (mokhoa le litekanyetso)
Nka pilisi e le 'ngoe ka molomo makhetlo a mararo ka letsatsi pele ho lijo. E sebelisoa e le adjuential ho kopantseng kalafo. Tekanyetso li hlalosoa ke ngaka e eang motheong oa tlhahlobo. Motsoako oa pele ke 25 mg. U ka eketseha butle-butle, empa ka nako e ts'oanang lekola nts'etsopele ea litla-morao. Boholo bo behiloeng ke 600 mg ka letsatsi. Nako ea kalafo ke bonyane likhoeli tse 6. Ho bohlokoa haholo ho latela lijo.
Bongata
Ho na le bohloko ba ka mpeng, lets'ollo le botlaela. Matšoao a tlosoa ka ho se kenye lijo tse nang le lik'habohaedreite tse tsoang lijong.
Ka kalafo e kopaneng, hypoglycemia e ka hlaha. Matšoao a eona: bofokoli, pallor, ho se tsebe hantle (ho fihlela mokokotlo), tlala, kizungu, joalo-joalo. E leka-lekaneng ebile e matla e felisoa ka ente ea glucagon kapa tharollo ea dextrose. Maemong ana, ho hlokahala phetoho ea tekanyetso.
Ho sebelisana le lithethefatsi
Fokotsa litlamorao tsa adsorbents tsa ka mpeng le li-enzyme.
E ntlafatsa ketso ea insulin, metformin, sulfonylurea, e sokelang nts'etsopele ea hypoglycemia.
Lintho tse latelang li nyenyefatsa phello ea acarbose:
- thiazide diuretics,
- lihomo tsa qoqotho
- corticosteroids
- phenytoin
- phenothiazines,
- kutloelo-bohloko
- estrogens, lithibela-pelehi tsa molomo,
- calcium antagonists
- nicotinic acid
- isoniazid le mahlahana a mang a bakang hyperglycemia.
Ha ho na litšebelisano tse itseng le karabelo tse boletsoeng. Ka kakaretso ho bonolo ho e mamella.
Ho bapisoa le li-analogues
Acarbose ke karolo ea lithethefatsi tse ngata. Nahana ka likarolo le likarolo tsa bona ka botlalo.
E hlahisoa ke Bayer Jeremane ka litekanyetso tse peli - 50 le 100 mg. Hangata sena se laeloa ke lingaka. Theko - li-ruble tse 360-500, ho latela palo ea lintho. Glucobay e thehiloe hantle 'marakeng oa lithethefatsi, ke sesebelisoa se sebetsang sa ho theola boima ba lefu la tsoekere hammoho le kalafo ea phepo.
E hlahisoa ke k'hamphani ea moetso ea Turkey. Pilisi 50 kapa 100 mg. Motsoako o sebetsang oa lefu la tsoekere, o na le litlhahlobo tse ntle. Nyane - ho thata ho kena lik'hemisteng tsa Russia.
E na le liraglutide, e amang ts'ebetso ea lisele tsa beta manyeme. E baka ho fokotseha ha tsoekere ea mali, hanyane ka hanyane ho theola letho ka mpeng, e thusang ho theola boima ba 'mele. Likopo li tšoana le acarbose. E fumaneha ka tsela ea tharollo bakeng sa tsamaiso e tsamaeang ka tlas'a lefatše. Mohlahisi - "Novo Nordisk", Denmark. Theko - ho tloha li-ruble tse 9000 bakeng sa lipeni tse peli tsa syringe. Abela ha matlapa a sa sebetse. Mohlaseluoa a ka sebelisoa bakeng sa kalafo e kopaneng le insulin le lithethefatsi tse ling tsa hypoglycemic.
Matlapa a Metformin bakeng sa kalafo e rarahaneng. Ho tloha ho li-ruble tse 500 ka pakete e ngoe le e ngoe. Pilisi e fapane, kalafo e laetsoe ho latela litlhoko tsa motho ka mong. E entsoe ke feme ea Berlin-Chemie, Jeremane. E ama ho sebetsa ha lisele tsa beta manyeme, e thusang ho fokotsa khatello ea tsoekere le ho boloka boima ba mmele bo le bobebe. Meaho ea tšoana, hangata e nkela e mong sebaka. Minus feela ea Siofor ke hore metformin ha e loketse motho e mong le e mong. Contraindication e tšoana.
Ts'ebeliso ea analogue efe kapa efe e etsoa ka tumello ea ngaka e eang. Ho ikoetlisa ho thibetsoe!
Ka kakaretso, litlhahlobo tsa lefu la tsoekere ka lithethefatsi tse thehiloeng ho acarbose li ntle. Bakuli ba bang ba hlokomela nts'etsopele ea litla-morao ka mokhoa oa ho bata le mathata a mang a lijo. Hoo e batlang e le motho e mong le e mong o bua ka phokotso ea mmele e tsitsitseng le phokotso ea tsoekere ea mali.
Natalya: "E se e le khoeli joale ke nka Glucobay. Ho qala ka 50 mg ka keletsong ea ngaka, joale e hlahisitsoe ho 100 mg. Ho kopanya le Novonorm. Tsoekere ea mantsiboea le eona e ile ea latela. Le ha ke khaotsa ho ja, ha a tsilatsile. Empa ho na le litla-morao ka mokhoa oa ho sitisa mala. Ka hona, ke leka ho latela litaelo tsa ngaka le ho latela mokhoa oa ho ja. ”
Vladislav: "Ngaka e ngotse" Glucobai ", e nang le acarbose, kamora hore ke alejane le metformin. Bakeng sa theko, sethethefatsi sena se nkotla, ke se sebelisa e le moriana o eketsehileng. Taolo ea kokoana-hloko e se e fetohile e thabileng, ho thabile hore ebe ha ho na hypoglycemia. Qalong ea kalafo ho ne ho bataletse, ngaka e ile ea beha litlhare tse ling, tsohle li khutlela ho tloaelehileng. Ke khahliloe ke phello, 'me boima ba eona bo tsitsitse, boo esale ke leka ho bo fumana ka nako e telele. ”
Oleg: “Ke na le lefu la tsoekere la mofuta oa 2. Ho bile le mathata a ho khethoa ha moriana o mong bakeng sa thupelo ea sehlooho. Ke ne ke se ke lekile matlapa a 'maloa ka metformin, empa ha a nkeke ho ea ka lipontšo (mathata a liphio). Ngaka e khothalelitse ho leka moriana o thehiloeng acarbose, e leng, "Glucobay". Ke se ke e nkile khoeli joale, ke rata tsohle. Haufinyane, litekanyetso li eketsehile ho 100 mg - ntle le litlamorao. Ba re lithethefatsi tsa metformin li sebetsa haholoanyane, empa ho nkama. Kahoo ke u eletsa. ”
Larisa: “Ke ile ka khetheloa Glucobai. Ngaka e ile ea mo rorisa, a re ka boeona ha e bake hypoglycemia. Ke noele hoo e ka bang 50 mg ka nako e ka etsang khoeli. Ke ne ke na le mathata ka mala, ao ke neng ke sitoa ho a tlosa. Ke ile ka tlameha ho tlohela lipilisi tsena 'me ka fetohela insulin ka ho feletseng. ”
Qeto
Meriana e nang le Acarbose e lula e thusa batho ba nang le lefu la tsoekere ho ntlafatsa tsoekere le boima. Lithethefatsi li laetsoe maemong a mangata, empa kamehla li kopana le ba bang bakeng sa phello e ntle. Tlhahlobo ea bakuli le lingaka e ntle haholo, acarbose e ngata e loketse ebile e fana ka sephetho sa nako e telele.
Na ke lokela ho noa lipilisi?
Ka likhakanyo tsa tsoekere tse tloaelehileng, ho sebelisa lipilisi tsa ho ja ha ho na thuso. Ho seng joalo, litla-morao kapa mathata a tebileng a bophelo bo botle a lokela ho lebelloa.
Ho khothalletsoa lipilisi tsa lefu la tsoekere hore o noe le:
- Likhato tse 2 tsa lefu lena,
- sethala sa lefu lena
- li-pathologies tse ling tse halefisoang ke ho eketseha ha tsoekere maling.
Hobaneng lefu la tsoekere le ntse le nona?
Ho nona ho bonoa ho 88% ea batho ba nang le lefu la tsoekere.
Ka tloaelo, insulin ea 'mele e thusa ho fokotsa tsoekere e maling le ho e fetisetsa liseleng. Khahlano le nalane ea nts'etsopele ea lefu la tsoekere mellitus, mokhoa ona oa senyeha.
Ela hloko! Boemong ba 1 ba lefu lena, ho itšireletsa ha insulin hoa bonoa. Boemo bona bo khetholloa ke keketseho e ts'oanang ea li-glucose le li-insulin.
Sena se tsosa keketseho ea motsoako oa liprotheine le mafura mme se lebisa ho khatello ea li-enzyme tse arolang mafura. Khahlano le semelo sena, botena bo a hlaha.
Melao e khothalelitsoeng
Letlapa le supa lithethefatsi tse thusang ho theola boima ba 'mele ho lefu la tsoekere la mofuta oa 2.
Lethathamo 1. Lithethefatsi tse hlasimollang tsa mofuta oa 2 lefu la tsoekere:
| Lithethefatsi | Tlhaloso |
 Metformin | E thibela "hepatic gluconeogeneis", 'me e thusa ho fokotsa ho monya ha glucose ka mpeng. Hape, lithethefatsi li amahanngoa le ts'ebeliso e ngata ea glucose e eketsehileng. Tissue insulin hypersensitivity ea eketseha. Boima ba 'mele boa tsitsa kapa boa fokotseha. |
 Glucophage | Moemeli oa hypoglycemic ea molomo. Ke ea Biguanides. E thusa tlhahiso e tlase ea tsoekere ea sebete. Sena se etsahala khahlano le semelo sa thibelo ea glycogenolysis le gluconeogeneis. Boima bo tsitsa kapa butle-butle boa fokotseha. |
 Siofor | Ho sa tsotelehe hore na litlamorao tsa tsoekere ea mali ke eng, moriana o na le phello e molemo ho metabolism ea lipid. Sena se thusa ho theola cholesterol e felletseng, hammoho le triglycerides le cholesterol e tlaase e tlase. |
 Metfogamma | Setlhare sena se tsamaea le ho fokotseha hoa LDL le triglycerides. Boima ba mokuli boa tsitsa kapa butle-butle bo khutlela ho bo tloaelehileng. |
 Diaformin | Dimethylbiguanide. E lumellana le ho fokotseha ha mahloriso a VLDL, LDL, triglycerides. Boima ba mokuli boa tsitsa kapa bo fokotseha ka tsela e itekanetseng. |
 Ascarbose | Alpha glucosidase inhibitor. Setlhare se fanoa khahlano le semelo sa ho se sebetse hantle ha lijo. Hape, moriana o ka nooa ha o ntse o fuoa meriana e kopaneng. |
Lithethefatsi tse ling tse thellang
Mosebetsi o ka sehloohong oa ho sebelisa meriana bakeng sa ho theola boima ba 'mele ke ho fihlela taolo e felletseng ea metabolic le ho emisa kotsi ea keketseho ea khatello ea tsoekere ea mali.
Bakeng sa ho fokotsa boima ba lefu la tsoekere, lihlopha tse latelang tsa lithethefatsi li laetsoe:
- biguanides
- litokisetso tsa sulfonylurea
- glitazones
- Clinids
- alpha glucosidase inhibitors
- DPP-4 inhibitors.
E 'ngoe le e' ngoe ea lihlopha tsa lithethefatsi e thusa ho laola boima ba 'mele le ho kenya letsoho phokotso ea eona butle butle.
Khothaletso ea Biguanides
Lithethefatsi tse sehlopheng sena li thehiloe ho metmorphine. Biguanides - se seng sa lihlopha tse tsebahalang tsa meriana, se tsebahalang har'a batho ba nang le lefu la tsoekere. Moriana o laetsoe ho tloha bohareng ba lilemo tsa bo-50 lekholong.
Lethathamo la 2.
| Lithethefatsi | Tlhaloso |
 Avandamet | Moriana oa molomo oa hypoglycemic. Khahlano le semelo sa phokotseho ea tsoekere ea mali, phetoho taolong ea metabolic e bonoa. Litaba tsa k'holeseterole e felletseng, TG le LDL le tsona li fokotsehile. |
 Bagomet | Lithethefatsi li theola hepatic glucogenesis. Ho kenella ka har'a glucose ea kahare ho fokotsehile. Tšebeliso ea matla a tsoekere e ntse e eketseha. Boima bo itšepa ka botsitso kapa butle-butle boa fokotseha. |
 Metformin-Akrikhin | Moriba o thibela gluconeogeneis, o thibela "tsoalo" ea mafura acids le mafura a oxidation. Boima ba 'mele boa tsitsa pele, ebe bo ea fokotseha butle butle. |
Ela hloko! Meriana ea sehlopha sena e kenya letsoho ho hlaheng ha litla-morao. Ka hona, ba khethoa feela maemong a ikhethang.
Sulfonylureas e sebetsang ka ho fetisisa
Morero o ka sehloohong oa lithethefatsi tsa sehlopha sena ke ho susumetsa lisele tsa pancreatic beta ho hlahisa insulin. Lithethefatsi li fanoa ha matšoao a mokhathala a hlaha.
Lethathamo la 3. Ts'ebeliso ea litokisetso tsa sulfonylurea:
| Bongaka | Ho joang? |
 Lefu la tsoekere | Ke sulfonylurea e tsoang meloko e 2. Tšebeliso ea lithethefatsi e thusa ho fokotsa nako ea ho tlohelloa nako ea ho ja ho fihlela qalong ea secretion ea insulin. E tsamaisana le ho khutlisetsa tlhoro ea pele ea insulin secretion, e fokotsa tlhoro ea postprandial ea hyperglycemia. Hape, moriana o thusa ho fokotsa palo ea li-radicals tsa mahala. |
 Amaril | Ke litokollo tsa meloko e meraro tsa sulfonylurea. E na le phello ea insulinomimetic. E kenya letsoho taolong ea secretion ea insulin. Sena se bakoa ke ho kopanngoa ha liketane tsa potasiamo tsa potasiamo tsa ATP tse nang le membrane ea sele ea beta. |
 Setšoantšong Glimepiride | E thusa ho tsosa secretion le ho lokolloa ha insulin liseleng tsa pancreatic beta. E boetse e na le phello ea extrapancreatic. E khothalelitsoe lefu la tsoekere la mofuta oa 2. |
 Diameride (Dimexide) | E thibela ho kopana ha liplatelete. Sena se bakoa ke ho fokotseha ha phetoho ea arachidonic acid ho thromboxane A2. Matla a anti-atherogenic a lithethefatsi a bakoa ke ho fokotseha ha litaba tsa malondialdehyde maling. |
 Glemaz | E khothalletsa ho lokolloa ha insulin, e na le ts'ebetso ea extrapancreatic. E khothalelitsoe lefu la tsoekere la mofuta oa 2. |
Meriana ea sehlopha sena e boetse e fanoa maemong a ikhethang. Sena se bakoa ke kotsi ea hypoglycemia. Theko ea lithethefatsi e fapana ho tloha ho 147 ho isa ho 463 li-ruble.
Glitazones e khothalelitsoeng
Lithethefatsi tse theolelang tsoekere tse fuoeng ho fokotsa khatello ea insulin.
Lethathamo la 4. Li-glitazones tse sebetsang ka ho fetisisa:
| Lithethefatsi | Tlhaloso |
 Avandaglim | E thusa ho ntlafatsa ho lokolloa ha insulin ke lisele tse phetseng hantle tsa pancreatic beta. E fuoe kalafo ea ho kopanya, lefu la tsoekere la mofuta oa 2. Ka lebaka leo, ntlafatso ea synergistic taolong ea glycemic e bonoa. |
 Peoglar | Ke agonist e matla e khethang ea gamma receptor. Ts'ebetso ea bona e hlahisoa ke proliferator peroxisome. Ho hanyetsoa ha insulin likarolong tse poteletseng le tsa sebete ke ntho e tloaelehileng. Ka DM-2, ho fokotseha hoa khatello ea TG le keketseho ea boemo ba HDL ho bonoa. |
 Ka tloaelo Diab | E thusa ho fokotsa ho hanyetsoa ha insulin liseleng tse ka thoko le bokong. Moriana ha o fuoe mofuta oa lefu la tsoekere le itšetlehileng ka insulin. |
 Astrozone | E lumellana le ho fokotseha ha insulin ho hanyetsa. Sena se bakoa ke ts'ebetso ea pioglitazone. Ka nako e ts'oanang, boemo ba tsoekere ea mali boa fokotseha. Tekanyetso ea insulin ea plasma le eona e ea fokotsoa. |
 Diaglitazone | Moriana o thusa ho fokotsa bongata ba li-triglycerides le ho eketsa litaba tsa lipoprotein tse phahameng, hammoho le cholesterol. Secretion ea "insulin" ha e khothalletsoe. |
Ela hloko! Hammoho le Metformin, lithethefatsi sehlopheng sena li thusa ho theola boima ba 'mele kapele haholo.
Litliliniki tse Atlehang ka ho Fetisisa
Tsena ke lintho tse khothatsang tsa insulin ka nakoana. E abetsoe ho laola maemo a tsoekere ka mor'a lijo.Boima bo ameha ha feela ho laetsoe ka monotherapy.
Lethathamo la 5. Tšebeliso ea litlolo:
| Lithethefatsi | Ho joang? |
 Novonorm | E thusa ho thibela li-tubules tse itšetlehileng ka ATP ka har'a li-membrane tsa lisele tsa beta. Kamora halofo ea hora ka mor'a ho nka moriana, ho na le karabelo ea insulinotropic. Sena se thusa tsoekere e maling. |
 Inswada | Ke mokhoa o potlakisang tšebetso oa molomo oa ho boloka insulin kapele. E thusa ho tsepamisa mohopolo maling. Sena se bakoa ke ho hlohlona ha secretion ea insulin ke manyeme. Hape, moriana o tsamaea le ho koaloa ha li-tubules tse itšetlehileng ka ATP tsa potasiamo ka membrane ea lisele tsa beta. Bakeng sa sena, ho sebelisoa protheine e khethehileng. Ka lebaka leo, liteishene tsa khalsiamo lia buleha. |
 Starlix | E tsoa ho amino acid phenylalanine. E khothalletsa ho tsosolosoa ha secretion ea insulin pele. Khahlano le semelo sena, khatello ea "glucose" ea "postprandial" e maling e ea fokotseha. Litaba tsa hemoglobin ea glycated le tsona li tloaelehile. |
Khothaletso ea Alpha Glucosidase Inhibitors
Lithethefatsi li thusa ho liehisa ho kenngoa ha k'habohaedreite. Sena se lebisa ho se khonehe ha keketseho e matla ea khatello ea tsoekere maling. Khahlano le semelo sa taolo, hemoglobin ea glycated e tloaelehile, khanyetso ea insulin e fokotseha.
Lethathamo la 6. Tšebeliso ea li-inhibitors tsa alpha-glucosidase:
| Bongaka | Tlhaloso | ||||||||||
 Acarbose | Oligosaccharide e tsoang ho microorganism Actinoplanes utahensis. Setlhare se khothaletsa ho phatloha hoa di-tri - le oligosaccharides ka lumen ea mala a manyane. Ho fufuleloa hoa fokotseha, mefuta ea tsoekere ka mpeng. Hape, lithethefatsi li amahanngoa le ho fokotseha ha postprandial hyperglycemia. | ||||||||||
 Glucobay | Pseudotetrasaccharide ea tlhaho ea microbial. E thibela ka hare ho enzyme alpha glucosidase ea ka mpeng, e theolang polydi le oligosaccharides. | ||||||||||
 Miglitol | E thusa ho fokotsa phallo ea tsoekere maling le ho fokotsa tsoekere ea mali ka mor'a ho ja. | ||||||||||
 Diastabol | E tsamaisana le ho fokotseha ha hyperglycemia kamora ho ja, e boreleli profil ea mahloriso a lihora tse 24. E thusa tsoekere e potlakileng ea mali. Motsoako oa hemoglobin ea glycosylated o fokotsehile. Setlhare ha se ame ho kenngoa ha glucose ea phepo. Lintho tse atlehang haholo tsa enzyme DPP-4Lithethefatsi sehlopheng sena li na le phello ho lihomone tsa tšilo ea lijo. Li laetsoe ho laola boima ba 'mele. Lethathamo 7. Tšebeliso ea li-inhibitors tsa enzyme DPP-4:
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Sitagliptin
Vildagliptin
Linagliptin
Saxagliptin
Chromium e khutlisetsa kutloisiso ea insulin liseleng
