Analogue ea matlapa a Diagnlinid

Sehloohong sena, o ka bala litaelo tsa ho sebelisa lithethefatsi Repaglinide. E fana ka maikutlo a tsoang ho baeti sebakeng sena - bareki ba meriana ena, hammoho le maikutlo a litsebi tsa bongaka mabapi le tšebeliso ea Repaglinide ts'ebetsong ea bona. Kopo e kholo ke ho kenyelletsa maikutlo a hau ka sethethefatsi sena: moriana o thusitseng kapa o sa thusa ho felisa lefu lena, hore na ho bile le mathata afe kapa afe, mme mohlomong a sa phatlalatsoe ke moetsi ho phatlalatso. Analogs of Repaglinide boteng ba li-analogues tsa sebopeho se fumanehang. Sebelisa bakeng sa kalafo ea lefu la tsoekere le sa itšetleheng ka insulin ho batho ba baholo, bana, esita le nakong ea kemaro le ho beleha. Sebopeho sa moriana le tšebelisano ea oona le joala.

Repaglinide - moemeli oa hypoglycemic ea molomo. Ka potlako e theola tsoekere ea mali kapele ka ho susumetsa tokollo ea insulin ho lisele tse sebetsang tsa pancreatic beta. Mochine oa ts'ebetso o amahanngoa le bokhoni ba ho thibela liketane tse itšetlehileng tsa adenosine triphosphate (ATP) ka ho sebetsa ka li-membrane tsa beta-cell ka ho sebetsa ka li-receptor tse ikhethileng, tse lebisang ho nyenyefatseng ha lisele le ho buloa ha liteishene tsa calcium. Ka lebaka leo, protocol e eketsehileng ea calcium e kenya secretion ea insulin ka lisele tsa beta.

Kamora ho nka Repaglinide, karabelo ea insulinotropic ho lijo e bonoa ka nako ea metsotso e 30, e lebisang ho fokotseha ha tsoekere ea mali. Pakeng tsa lijo, ha ho na keketseho ea khatello ea insulin. Ho bakuli ba nang le mofuta oa lefu la tsoekere la mofuta oa 2 mellitus (o sa itšetleheng ka insulin) ha o nka Repaglinide ka tekanyetso ea 500 μg ho isa ho 4 mg, o fokotsehile ka tekanyo e thehiloeng ka tekanyo ea likhaba tsa tsoekere ea mali.

Sebopeho

Repaglinide + excipients.

Mofumahali

Kamora ho tsamaisoa ka molomo, repaglinide e kenella ka potlako ho tsoa pampiring ea gastrointestinal (GIT), ha khatello ea eona e phahameng maling e fihlella hora e le 1 kamora ho kenella, ebe boemo ba repaglinide ho plasma bo fokotseha ka potlako mme kamora lihora tse 4 e ba tlase haholo. Ho ne ho se na phapang e kholo lithutong tsa pharmacokinetic ea repaglinide ha e ne e nkuoa hang-hang pele ho lijo, metsotso e 15 le e 30 pele ho lijo kapa ka mpa e se nang letho. Plasma protein e tlamang e fetang 90%. Repaglinide e batla e le biotransformed ka ho phethahetseng sebeteng ka ho theha metabolites e sa sebetseng. Repaglinide le metabolites ea eona li hlahisoa haholo ka bile, e ka tlase ho 8% - ka moroto (joalo ka metabolites), ka tlase ho 1% - e nang le makhopho (a sa fetoheng).

Matšoao

• mellitus e sa itšetleheng ka insulin (mofuta oa 2 lefu la tsoekere).

Lokolla liforomo

Matlapa a 0.5 mg, 1 mg le 2 mg.

Litaelo tsa mokhoa oa ho sebelisoa le oa litekanyetso

Mokhoa oa ho fokotsa litekanyetso o beoa ka bonngoe, o khetha lethal dose ho ntlafatsa tsoekere ea glucose.

Motsoako oa ho qala o khothalelitsoeng ke 500 mcg. Ho eketsa tekanyetso ha hoa lokela ho etsoa ntle le ka mor'a libeke tse 1-2 tsa ho kenella khafetsa, ho latela maemo a laboratori ea metabolism ea carbohydrate.

Boleke ba boholo: single - 4 mg, letsatsi le letsatsi - 16 mg.

Kamora ho sebelisa moriana o mong oa hypoglycemic, moriana oa ho qala o khothalelitsoeng ke 1 mg.

E amoheloa pele ho lijo tse ka sehloohong. Nako e nepahetseng ea ho sebelisa moriana ke metsotso e 15 pele o e-ja, empa e ka nooa metsotso e 30 pele ho lijo kapa hang pele lijo.

Litla-morao

• phello ho metabolism ea carbohydrate - maemo a hypoglycemic (pallor, mofufutso o eketsehang, palpitations, mathata a ho robala, ho thothomela),
• Ho fokotseha hoa maemo a tsoekere ea mali ho ka baka ho senyeha ha nakoana hoa pono, haholo ts'imolohong ea kalafo (ho hlokometsoe ka palo e fokolang ea bakuli mme ha ho hloke ho khaotsoa ha moriana).
• bohloko ba ka mpeng
• lets'ollo, ho sokela,
• ho nyekeloa, ho hlatsa,
• mosebetsi o eketsehileng oa li-enzyme tsa sebete,
• karohano ea ho kulisa: ho hlohlona, ​​erythema, urticaria.

Contraindication

• mofuta oa 1 lefu la tsoekere (ho itšetleha ka insulin),
• lefu la tsoekere la ketoacidosis (ho kenyeletsoa le ho akheha),
• Ho senyeha ha real,
• ho hloka matla ha sebete,
• Phekolo e kopanetsoeng le lithethefatsi tse thibelang kapa tse hohelang CYP3A4,
• boimana (ho kenyeletsoa le rerile) le ho anyesa (ho anyesa),
• hypersensitivity ho repaglinide.

Bokhachane le pelehi

Ts'ebeliso ea Repaglinide nakong ea bokhachane le lactation e hatelloa.

Boithutong ba liteko, ho fumanoe hore ha ho na phello ea teratogenic, empa ha e sebelisoa ka tekanyetso e phahameng ho likhoto mohatong oa ho qetela oa kemaro, ho emisoa le ho holofala ha litho le matsoho ka popelong.

Repaglinide e hloekisoa lebeseng la matsoele.

Sebelisa ho bana

Kopo bongoaneng ha e hlalosoe.

Litaelo tse khethehileng

Ho mafu a sebete kapa a liphio, ho buuoa haholo, ka mor'a ho kula kapa tšoaetso ea morao-rao, ho fokotseha hoa katleho ea Repaglinide hoa khoneha.

Sebelisa ka hloko ho bakuli ba nang le lefu la liphio.

Ho bakuli ba holofetseng kapa ho bakuli ba nang le phepo e fokotsang, Repaglinide e lokela ho nkuoa ka tekanyetso e fokolang ea pele le ea tlhokomelo. Ho thibela karabelo ea hypoglycemic sehlopheng sena sa bakuli, lethal dose le lokela ho khethoa ka hloko.

Maemo a ntseng a phahama a hypoglycemic hangata a karabelo e leka-lekaneng 'me a emisoa habonolo ke tšebeliso ea lik'habohaedreite. Maemong a thata, ho ka hlokahala hore o tsamaise tsoekere kahare. Monyetla oa ho ba le maikutlo a joalo o ipapisitse le tekanyetso, litšobotsi tsa phepo e nepahetseng, matla a ts'ebetso ea 'mele, khatello ea maikutlo.

Ka kopo hlokomela hore beta-blockers e ka pata matšoao a hypoglycemia.

Nakong ea kalafo, bakuli ba lokela ho hana ho noa joala, hobane ethanol e ka ntlafatsa le ho lelefatsa phello ea hypoglycemic ea Repaglinide.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Khahlano le semelo sa tšebeliso ea Repaglinide, monyetla oa ho khanna koloi kapa ho etsa lintho tse ling tse kotsi o lokela ho hlahlojoa.

Ho sebelisana le lithethefatsi

Tšusumetso ea hypoglycemic ea Repaglinide e ntlafatsoa ka tšebeliso e tšoanang ea li-inhibitors tsa monoamine oxidase (MAO), li-blockers tse se nang khetho, li-lingiotensin-converting enzyme (ACE), li-salicylates, lithethefatsi tse seng tsa steroidal tse thibelang ho ruruha (NSAIDs), octreotide, anabolic steroids.

Ho fokotseha hoa phello ea hypoglycemic ea Repaglinide hoa khoneha ka tšebeliso e ts'oanang ea lithibela-mafu tsa lihormone bakeng sa tsamaiso ea molomo, thiazide diuretics, glucocorticosteroids (GCS), danazole, lihormone tsa qoqotho, sympathomimetics (ha o fana ka litlhare kapa o hlakola lithethefatsi tsena, ho hlokahala hore ho be le maemo a mmele ka hloko.

Ka tšebeliso e tšoanang ea repaglinide le lithethefatsi tse hlahisoang haholo kahare, monyetla oa tšebelisano e ka bang teng lipakeng tsa bona o lokela ho tsotelloa.

Mabapi le data e fumanehang ka metabolism ea repaglinide ke CYP3A4 isoenzyme, tšebelisano e ka khonehang le CYP3A4 inhibitors (ketoconazole, intraconazole, erythromycin, fluconazole, mibefradil), e lebisang keketseho ea repaglinide ea plasma, e lokela ho tsotelloa. Li-Inducers tsa CYP3A4 (ho kenyeletsa rifampicin, phenytoin) li ka fokotsa khatello ea li-repaglinide ho plasma. Kaha degree ea induction ha e e-so thehisoe, tšebeliso e tšoanang ea repaglinide le lithethefatsi tsena e hatelloa.

Likhatiso tsa lithethefatsi Repaglinide

Analogue ea sebopeho sa ntho e sebetsang:

Analogues ea lithethefatsi Repaglinide ke sehlopha sa lithethefatsi (synthetic hypoglycemic le lithethefatsi tse ling):

• Avandia
• Adebite
• Acarbose
• Antidiab
• Arfazetin,
• Astrozone
• Bagomet,
• Betanase
• Bukarban,
• Victoza
• Vildagliptin,
• Vipidia,
• Galvus
• Gilemal
• Glibenez
• Glibenclamide,
• Glyclazide
• Glycon
• Glimepiride
• Glyminfor,
• Glyformin
• Glucophage,
• Guarem
• Lefu la tsoekere
• Diamerid,
• Diastabol,
• Eglinides
• Xelevia,
• Lycumia,
• Maninil
• Metformin
• Minidiab
• Movoglechen
• Nateglinide
• Onglisa,
• Peoglar
• Peoglite
• Pheta hape
• Rosiglitazone,
• Saxenda
• Saterex,
• Siofor
• Sofamet
• Statiglin,
• Trazenta,
• Thoriso
• Foromo,
• Foromo
• Forsiga
• Chlorpropamide
• Blueberry ea hlaha
• Euglucon,
• Yuglin,
• Januvius
• Yasitara.

Maikutlo a Endocrinologist

Repaglinide ea lithethefatsi Ke fumana bakuli ba bang ba nang le lefu la tsoekere la mofuta oa 2. Ke khetha litekanyetso tsa motho ka mong le tsa letsatsi le letsatsi bakeng sa mokuli ka mong 'me ke li chencha, ke ntse ke lekola boemo ba tsoekere maling. Ho hantle hore bakuli ba bangata ba nang le lefu la tsoekere ba na le li-glucometer tsa bona, e leng ho nolofalletsang ho hlahloba matla a glycemia nakong ea khetho ea litheko le ho feta nakong ea kalafo. Ho mamella lithethefatsi Repaglinide ho nepahetse. Ha ke hopole hore e mong oa bakuli ba e sebelisang o lula a tletleba ka litla-morao tse ling.

Analogues ea lithethefatsi Diagninid

Analogue e theko e tlase ho tloha ho 0 rub.

Jardins ke setlhare se tsoang kantle ho kalafo ea lefu la tsoekere la mofuta oa 2. Empagliflozin ka bongata ba 25 mg ho pilara e sebetsa e le eona feela karolo e sebetsang. Jardins o na le li-contraindication le lithibelo tsa lilemo, ka hona, buisana le ngaka ea hau pele u qala kalafo.

Analogue e theko e tlaase ho tsoa li-ruble tse 59.

Moetsi: Novo Nordisk (Denmark)
Mefuta ea Tsamaiso:

• Tab. 1 mg, li-pcs tse 30., Theko e tsoang ho li-ruble tse 175
• Tab. 2 mg, li-pcs tse 30., Theko e tsoang ho li-ruble tse 219

Litheko tsa NovoNorm ka litlhare tsa marang-rang
Litaelo tsa ho sebelisoa

NovoNorm ke litokisetso tsa letlapa tse tsoang sehlotšoaneng se tšoanang sa meriana, empa ka ntho e fapaneng e sebetsang. Repaglinide e sebelisoa mona ka tekanyetso ea 0.5 ho isa ho 2 mg. Matšoao a ho hlahisoa a tšoana, empa li-contraindication li fapana ka lebaka la DV e fapaneng matlapeng, kahoo bala litaelo ka hloko 'me u buisane le ngaka ea hau.

Analogue e theko e phahameng haholo ho tloha ho li-ruble tse 2219.

Moetsi: E ntse e hlakisoa
Mefuta ea Tsamaiso:

• Tab. p / obol. 100 mg, li-pcs tse 30., Theko e tsoang ho li-ruble tse 2453
• Tab. 2 mg, li-pcs tse 30., Theko e tsoang ho li-ruble tse 219

Litheko bakeng sa Invokana liindastering tsa marang-rang
Litaelo tsa ho sebelisoa

Novo Nordisk (Denmark) NovoNorm ke sebaka sa theko e tlaase sa Forsigi. Ntho feela e sebetsang ka har'a moriana ke repaglinide. Moriana ka nako ea metsotso e 30 o eketsa khatello ea insulin maling. Ka lebaka la khaello ea data lithutong tse entsoeng mabapi le polokeho ea lithethefatsi le tšebeliso e atlehileng ea matlapa sehlopheng sa lilemo tsa bana, ha ho kgothaletswe ho sebelisa moriana ona ho bana ba ka tlase ho lilemo tse 18. Ka mokhoa oa liphetoho tse bohloko, lets'ollo le bohloko ba ka mpeng hangata li etsahala hangata.

Analogue e theko e phahameng haholo ho tloha ho li-ruble tsa 1908.

Moetsi: E ntse e hlakisoa
Mefuta ea Tsamaiso:

• Tab. p / obol. 10 mg, li-pcs tse 30., Theko e tsoang ho li-ruble tse 2142
• Tab. 2 mg, li-pcs tse 30., Theko e tsoang ho li-ruble tse 219

Litheko bakeng sa Forsiga ka litlhare tsa marang-rang
Litaelo tsa ho sebelisoa

Forsiga ke litokisetso tsa letlapa bakeng sa kalafo ea mofuta oa 2 lefu la tsoekere le thehiloeng ho dapagliflozin ka litekanyetso tsa 5 mg. E kanna ea khethoa ntle le lijo tsa lefu la tsoekere le boikoetliso. Forsigi e na le li-contraindication le lithibelo tsa lilemo, bala ka hloko litaelo pele u qala kalafo.

Theko Repaglinide le phumaneho ea litlhare tsa litoropo tsa toropo

Hlokomela! Ka holimo ke tafole ea tlhaiso-leseling, tlhahisoleseling e kanna ea fetoha. Lintlha mabapi le litheko le phetoho li fumaneha ka nako ea 'nete ho li bona - o ka sebelisa patlo (kamehla ho fihlela tlhaiso-leseling e lipatlisiso), hape le ha o hloka ho siea taelo bakeng sa moriana, khetha libaka tsa toropo ho batla kapa ho batla feela ka ho bula hona joale li-pharmacy.

Lethathamo le ka holimo le ntlafalitsoe bonyane hang ka lihora tse ling le tse ling tse 6 (e ntlafalitsoe ka la 07/14/2019 ka 11: 47 - nako ea Moscow). Hlalosa litheko le ho fumaneha ha lithethefatsi ka lipatlisiso (bareki ea ho batla e ka holimo), le linomoro tsa mohala oa pharmacy pele u etela k'hemisteng. Tlhahisoleseling e fumanehang sebakeng sa marang-rang e ke ke ea sebelisoa e le likhothaletso tsa kalafo ea hau. Pele u sebelisa meriana, etsa bonnete ba hore u buisana le ngaka ea hau.

Litokisetso tsa repaglinide

Repaglinide ke lebitso la machaba leo ka lona lithethefatsi li ka khetholloang kae kapa kae lefatšeng. Joaloka motsoako o sebetsang, repaglinide ke karolo ea matlapa a hlahisoang ke lik'hamphani tse fapaneng tsa pharmacological tlasa lihlahisoa tsa tsona. Mabitso a latelang a khoebo ea repaglinide a ngolisitsoe ho ngoliso ea lithethefatsi tsa Russia:

Lebitso	Naha ea Phetoho ea Repaglinide	Naha ea tlhahiso ea matlapa	Ts'ebetso ea ID	Bophelo ba Shelf, lilemo
NovoNorm	Jeremane	Denmark	Novo Nordisk	5
Diaglinide	India, Poland	Russia	Akrikhin	2
Iglinid	Poland	Russia	Pharmasynthesis-Tyumen	3

Setlhare sa mantlha ke Danish NovoNorm. Lithuto tsohle tse kholo li entsoe ka ho nka karolo ha moriana ona o itseng. NovoNorm e fumaneha ka litekanyetso tsa 0.5, 1 le 2 mg, ka har'a pakete ea matlapa a 30. Theko ea pakete e tlaase - ho tloha ho 157 ho isa ho li-ruble tse 220. bakeng sa litekanyetso tse fapaneng.

Diagninid le Iglinid ke li-genics, kapa li-analogues tsa NovoNorma. Lithethefatsi tsena li hlahlojoa hore na li na le tsa mantlha, li na le phello e tšoanang le hypoglycemic le litekanyetso, boemo bo tšoanang ba polokeho. Litaelo tsa lithethefatsi li haufi haholo kamoo ho ka khonehang. Phapang ea bophelo ba lishelefo e hlalosoa ke sebopeho se fapaneng sa lintho tse thusang (tse sa sebetseng). Tlhahlobo ea batho ba nang le lefu la tsoekere ba netefatsa hore ea mantlha le analogue e fapana feela ka sebopeho sa tafole le sephutheloana. Theko ea Diclinid ke li-ruble tse 126 - 195. ka pakete e 'ngoe.

Iglinid ke mofuta o mocha ka ho fetisisa oa litokisetso tsa repaglinide tse ngolisitsoeng Russia. Moriana o ntse o qala ho hlaha marangrang a marang-rang. Ha ho lintlha tsa Iglinid hajoale.

Ketso ea pharmacological

Repaglinide ke derivative ea benzoic acid. Ntho ena e tlamahana le li-receptor tse ikhethang tse teng kahara metso ea lisele tsa beta, li thibela liteishene tsa potasiamo, li bula liteishene tsa khalsiamo, ka tsela eo li phahamisa secretion ea insulin.

Ketso ea ho repaglinide kamora ho sebelisa pilisi e qala kapele haholo. Tšusumetso ea pele ea moriana e fumanoa kamora metsotso e 10, ka hona, moriana o ka nooa hantle pele ho lijo. Khatello e kholo ka har'a likepe e fihlella ka mor'a metsotso e 40-60, e u lumellang hore o fokotse ho fokotsa glycemia ka potlako. Katleho e potlakileng ea Normoglycemia kamora ho ja e bohlokoa haholo ho tloha ntlheng ea pono ea ho thibela ho senyeha ha vascular bath ea lefu la tsoekere mellitus. Sekhahla se phahameng sa tsoekere, se tšoarellang ho tloha lijong tsa hoseng ho fihlela ka nako ea ho robala, se ntlafatsa ho eketseha ha mali, se khothaletsa mali, se baka tsitsipano ea lipid, se lebisa ho senyeha hoa thepa ea ts'ireletso ea methapo ea mali, 'me se baka khatello ea maikutlo khafetsa.

Ho fapana le sulfonylurea derivatives (PSM), phello ea repaglinide e ipapisitse le glycemia. Haeba e feta 5 mmol / l, sethethefatsi se sebetsa ka mafolofolo ho feta ka tsoekere e fokolang. Moriana o lahleheloa kapele, ka mor'a hore nako ea halofo ea repaglinide e ntšoe 'meleng. Kamora lihora tse 4, motsoako o fokolang oa lithethefatsi o fumanoa maling a sa khone ho ama glycemia.

Melemo ea repaglinide e nkang nako e khuts'oane:

1. Ho hlahisoa ha "insulin" ho haufi le tlhaho ka hohle kamoo ho ka khonehang.
2. Bokhoni ba ho fumana matšeliso a potlakileng bakeng sa lefu la tsoekere.
3. Ho fokotsa kotsi ea hypoglycemia. Ha u nka repaglinide, ha ho rekoto e le 'ngoe ea komello ea hypoglycemic e tlalehiloeng.
4. Ho haelloa ke hyperinsulinemia e phehellang. Sena se bolela hore batho ba nang le lefu la tsoekere ha ba na boima ba 'mele.
5. Ho fokotsa ho theoha ha beta ea cellular le tsoelo-pele ea lefu la tsoekere.

Repaglinide e ts'oaetsoa ka har'a sebete, 90% kapa ho feta ea ntho ena e kenyelitsoe mantle, ho fihlela ho 8% ea lethal dose e fumanoa ka har'a moroto. Likarolo tse joalo tsa pharmacokinetics li lumella ts'ebeliso ea lithethefatsi maemong a morao a lefu la tsoekere lephropathy le mafu a mang a mabe a liphio.

Matšoao a ho amoheloa

Repaglinide e etselitsoe mofuta oa 2 lefu la tsoekere feela. Tlhokahalo e tlamang ke ho ba teng hoa lisele tsa beta tse sebetsang. Ka li-algorithms tsa Russia le tsa kantle ho naha bakeng sa kalafo ea lefu la tsoekere mellitus, li-glinides li khetholloa e le lithethefatsi tsa pokello, li fanoa ha matlapa a mang a thibetsoe.

Matšoao a sebeliso:

1. E le mokhoa o mong oa ho sebelisa metformin, haeba e sa mamellehe hantle kapa e tiisitsoe. Ho bohlokoa ho nahana hore repaglinide ha e na phello e tobileng kutloisong ea lisele ho insulin, ho fokotseha ha tsoekere ho fumanoa feela ka ho hlola ho hanyetsa insulin ke boemo bo eketsehang ba lihormone.
2. Sebakeng sa litokollo tsa sulfonylurea, haeba mokuli a e-na le karabelo e matla ea allergic ho e 'ngoe ea lithethefatsi sehlopheng sena.
3. Ho matlafatsa mofuta oa kalafo, haeba lithethefatsi tse neng li laetsoe pele li khaotsa ho fana ka litekanyetso tsa tsoekere. Koetliso e u lumella ho kopanya repaglinide le metformin le insulin e telele, thiazolidatediones. Ka PSM, sethethefatsi se ke ke sa sebelisoa e le hore se se ke sa tlatsa lisele tsa manyeme haholo.
4. Ho ea ka lingaka, repaglinide e sebelisoa ka katleho ho batho ba nang le lefu la tsoekere ba hlokang phetoho e bonolo litekanyetsong tsa matlapa: ka ho ja ho feta tekano, ho tlōla lijo ka nako ea lijo tsa bolumeli.

Joalo ka pilisi efe kapa efe ea lefu la tsoekere, repaglinide e sebetsa hantle feela hammoho le lijo le boikoetliso.

Ha repaglinide e thibetsoe

Litaelo tsa tšebeliso li thibela ho fana ka litlhare ho basali baimana le ba anyang, bana le batho ba nang le lefu la tsoekere ho feta lilemo tse 75, hobane lihlopheng tsena tsa bakuli ha ho tiisoe tšireletso ea repaglinide.

Joalo ka lisebelisoa tsohle tsa molomo tse amanang le "hypoglycemic", "repaglinide" e ke ke ea sebelisoa ho mathata a lefu la tsoekere (ketoacidosis, hyperglycemic coma le precoma) le maemong a matla (likotsi, ts'ebetso, ho chesa kapa ho ruruha, tšoaetso e kotsi) - lenane la mathata ohle a hlobaetsang. Haeba boemo ba lefu la tsoekere bo hloka ho kena sepetlele, qeto ea ho hlakola matlapa le ho e fetisetsa ho insulin e etsoa ke ngaka e eang.

E le hore sethethefatsi se khone ho kenella ka potlako, ho hlokahala mesebetsi e sireletsehileng ea sebete. Maemong a ho hloleha ha sebete, kalafo e nang le repaglinide e thibetsoe ke litaelo.

Haeba mokuli ea nang le lefu la tsoekere a e-na le lefu la tsoekere a nka gemfibrozil bakeng sa tokiso ea boemo ba lipid ba mali, NovoNorm le Diagninid ha lia lokela ho laeloa, hobane ha li isoa hammoho, khatello ea maiketsetso maling e tsoha makhetlo a 2 kapa ho feta, mme hypoglycemia e kholo e ka khonahala.

Melao ea kamohelo

Repaglinide e tahiloe pele ho lijo tse ka sehloohong (lijo tsa hoseng, lijo tsa motšeare, lijo tsa mantsiboea, lijo tse bobebe). Haeba lijo li tlositsoe kapa li le ka ho eona ha ho na lik'habohaedreite, u se ke ua nka moriana. Ho latela maikutlo, kalafo ena ea kalafo e loketse bakuli ba bacha ba lefu la tsoekere ba nang le bophelo bo mafolofolo le bakeng sa bakuli ba tsofetseng ba nang le takatso e sa tsitsang ea lijo.

Tlhahisoleseling mabapi le tšebeliso ea moriana:

• khafetsa ea kamohelo - makhetlo a 2-4,
• nako pele ho lijo: khothalletsoa - Metsotso e 15, e amohelehang - ho fihlela halofo ea hora,
• Tekanyetso e le 'ngoe ea ho qala ke 0,5 mg bakeng sa lefu la tsoekere le sa tsoa fumanoa, 1 mg ha u fetoha phepelo ho tsoa litafoleng tse ling tse fokotsang tsoekere.
• tekanyetso ea eketseha haeba taolo ea lefu la tsoekere e sa lekana. Litekanyetso - maemo a phahameng a tsoekere ea mali ea postprandial le hemoglobin ea glycated,
• nako pakeng tsa keketseho ea litekanyetso li bonyane beke,
• Tekanyetso e le 'ngoe e phahameng ke 4, letsatsi le letsatsi 16 mg.

Ho latela likhothaletso tsa sejoale-joale, ho nka lipilisi tse fokotsang tsoekere ka tekanyo e kholo ha ho ratehe, kaha sena se eketsa kotsi ea litlamorao tsa tsona. Haeba 2-3 mg ea repaglinide e sa fane ka puseletso bakeng sa lefu la tsoekere, ho bohlokoa ho eketsa lithethefatsi tse ling, mme o seke oa eketsa tekanyetso ea meriana ena.

Ngaka ea Saense ea Bongaka, Hlooho ea Setsi sa Lefapha la Diabetes - Tatyana Yakovleva

Ke qetile lilemo tse ngata ke ithuta lefu la tsoekere. Hoa tšosa ha batho ba bangata ba shoa, mme le ho feta ba holofala ka lebaka la lefu la tsoekere.

Ke potlakela ho bolela litaba tse molemo - Setsi sa Patlisiso ea Endocrinological sa Russian Academy of Medical Science se atlehile ho hlahisa moriana o folisang lefu la tsoekere ka botlalo. Hona joale, katleho ea sethethefatsi sena e atametse 98%.

Litaba tse ling tse monate: Lekala la Bophelo le se le iphumanetse tšebetso ea lenaneo le ikhethileng bakeng sa litšenyehelo tse phahameng tsa lithethefatsi. Naheng ea Russia, ba lefu la tsoekere HO fihlela ka la 18 Motšeanong (ho kenyeletsoa) ka e fumana - Bakeng sa li-ruble tse 147 feela!

Litlamorao

Litlamorao tse atileng haholo tsa repaglinide ke hypoglycemia. Ho etsahala haeba insulin e ngata e tšolleloa maling ho feta kamoo ho hlokahalang bakeng sa ts'ebeliso ea tsoekere e kenang. Kotsi ea hypoglycemia e ipapisitse le lintlha ka bomong: tekanyetso ea lithethefatsi, litloaelo tsa ho ja, maemo a sithabetsang, nako le matla a ho ikoetlisa.

Litlamorao le khafetsa ea tsona ho latela litaelo tsa tšebeliso:

Monyetla oa hore o etsahale,%	Lintho tse fapaneng tse tla etsahala
ho fihla ho 10%	Hypoglycemia, lets'ollo, bohloko ba ka mpeng.
ho fihlela 0,1%	Acute coronary syndrome. Kamano le repaglinide ha e e-so theoe.
ho fihlela 0,01%	Boitšoaro bo kulisang, ho senyeha ha nakoana hoa pono mohato oa pele oa kalafo, ho sokela, ho hlatsa, ho senyeha ho fokolang ha sebete, maemo a eketsehileng a enzymes ea eona.

Ho sebelisana le lithethefatsi

Eketsa boemo ba repaglinide maling kapa e eketse tšebetso ea eona gemfibrozil, lithibela-mafu ka litlhaloso tse hlakileng le rifampicin, antifungals, immunosuppressant cyclosporin, li-inhibitors tsa MAO, li-inhibitors tsa ACE, li-NSAID, li-beta-blockers, salicylates, li-steroid, joala.

Lithibela-mafu tsa molomo, tse tsoang ho barbituric acid le thiazide, glucocorticoids, antiepileptic carbamazepine, lithethefatsi tsa sympathomimetic, lihormone tsa qoqotho li fokolisa phello ea repaglinide.

Ha o fana ka litlhare le ho hlakola lithethefatsi tse kaholimo, ho hlokahala maikutlo a ngaka le taolo ea glycemic hangata.

Repaglinide analogue

Analogue e haufi haholo ea repaglinide ke nateglinide ea phenylalanine, ntho e na le phello e ts'oanang le e khutšoane ea nakoana. Naheng ea Rashea, ho na le setlhare se le seng se nang le ntho ena e sebetsang - Starlix, moetsi oa "NovartisPharma" Nateglide bakeng sa hae e fumaneha Japane, matlapa ka boyona - Italy. Theko ea Starlix ke li-ruble tse likete tse 3 bakeng sa matlapa a 84.

Li-analogues tsa Budget - ho ata hohle ha li-PSM glibenclamide (Maninil), glycidone (Glyurenorm), glyclazide (Diabeteson, Diabetalong, Glidiab, jj) le glimepiride (Amaryl, Diamerid, jj.) Ba nka PSM hangata ho feta repaglinide, kaha phello ea bona e sa le telele.

Gliptins (Galvus, Januvia le li-analogs tsa bona), tse hlahisitsoeng ka mokhoa oa litafole le li-entretin mimetics (Baeta, Victoza) le tsona ke karolo ea baemeli ba ntlafatsang mantsoe a insulin. Litsenyehelo tsa kalafo ka li-gliptins li tsoa ho li-ruble tse 1500. Li-incretin tsa Mimetic li theko e boima haholo, ho tloha li-ruble tse 5200.

Etsa bonnete ba hore o ithuta! Na u nahana hore ho sebelisa lipilisi le insulin ka nako e telele ke eona feela tsela ea ho boloka tsoekere e le taolong? Ha se nnete! U ka netefatsa sena ka ho qala ho e sebelisa. bala haholoanyane >>

Sebopeho le litlhaloso tsa moriana

Letlapa le leng le le leng le na le 0.5 kapa 1 mg ea motsoako o sebetsang oa micagized repaglinide, e tlatselletsoang ka lisebelisoa tse thusang: calcium hydrogen phosphate anhydrous, colloidal silicon dioxide, cellcosestalline cellulose, croscarmellose sodium, hydroxypropyl cellulose, meglumine, magnesium stearate, dyes.

Matlapa a biconvex a pota-potileng a ka bonoa ka ho ngola linomoro tse bonts'ang litekanyetso. Ka letšoao la 0.5, li tšoeu, li na le 1 mg - lavender kapa 'mala o mosehla. Ka morao u ka bona khutsufatso RP, J le ba bang. Matlapa a 10 a pakiloe ka marang-rang. Ho tla ba le lipolanete tse joalo ka lebokoseng la karete.

Moriana oa ngaka o fumanehang. Theko ea Repaglinide ke tekanyetso e phethahetseng: matlapa a 30 a 2 mg ho la Moscow a ka rekoa li-ruble tse 200-220. Ba lokolla bongaka naheng ea Denmark, Israel, India le linaheng tse ling, ho kenyeletsoa le libakeng tsa post-Soviet.

Bophelo ba lishelefo tsa moriana, bo phatlalalitsoeng ke moetsi, ke ka kakaretso ea lilemo tse 3. Moriana ha o hloke maemo a khethehileng bakeng sa polokelo. Kamora nako e boletsoeng, matlapa a tlameha ho lahloa.

Litšobotsi tsa Pharmacological

Phello e ka sehloohong ea lithethefatsi ke hypoglycemic. Lithethefatsi li thibela lits'ebetso tse itšetlehileng ka potasiamo tsa ATP tse kahara membrane ea b-cell, li kenya letsoho ho fokotseha ha bona le ho lokolloa ha liketane tsa calcium. Kahoo, sephiri se etsa hore ho ratoe li-hormone.

Boithuto ba tsa bongaka ha bo fumane mutagenic, teratogenic, carcinogenic litlamorao ho liphoofolo le tsoalo e fokolang.

Repaglinide e kenella ka potlako le ka botlalo ho tsoa mohloling oa tšilo ea lijo, ho fihlela e fihla maling a eona ka hora.

Haeba e nooa le lijo, Cmax e fokotseha ka 20%. Khokahano ea lithethefatsi e theoha ka potlako mme kamora lihora tse 4 e fihla letšoao le tlase. Litlhare li tlama ho liprotheine tsa plasma hoo e batlang e le ka botlalo (ho tloha ho 98%) ka bioavailability ea 56%. Biotransformation le ho thehoa ha li-metabolites tsa inert e hlaha ka har'a sebete.

Setlhare se felisoa ka lihora tse 4-6 ka halofo ea bophelo ba hora ea 1. Ho 90% e feta ka har'a li-ducts tsa bile, hoo e ka bang 8% e hloekisoa ke liphio.

Repaglinide ke mang?

Moriana o etselitsoe ho laola lefu la tsoekere la mofuta oa 2 haeba mefuta ea mekhoa ea ho ja (lijo tse bobebe tsa carb, mojaro o lekaneng oa mesifa, taolo ea maikutlo) e sa fane ka taolo e felletseng ea glycemic.

Hoa khoneha ho sebelisa glinide kalafo e rarahaneng le metformin le thiazolidinediones, haeba monotherapy, phepo e nepahetseng ea phepo le ts'ebetso ea 'mele ha e fane ka sephetho se lakatsehang.

Ho Repaglinide ho ngolisitsoe mang

Ntle le lithibelo tsa moetlo (ho se mamelle motho ka mong, boimana, bana, matsoele), lithethefatsi li khahlanong le sena:

• Batho ba nang le lefu la tsoekere ba nang le lefu la 1,
• Ka lefu la tsoekere,
• E boemong ba ho akheha le ho hlaka,
• Haeba mokuli a e-na le mathata a ka mpeng le a sebete,
• Maemong a hlokang phetoho ea nakoana ho insulin (ts'oaetso, ho sithabela maikutlo, ho buoa).

Ho lokela ho lebisoa tlhokomelo e khethehileng ho khethang li-glinides ho lino tse tahang, batho ba nang le lefu la liphio le feberu e sa foleng.. Ho na le lithibelo tsa lilemo: u se ke ua fana ka litlhare ho lingaka tsa tsoekere pele ho lilemo tse 18 le kamora lilemo tse 75 ka lebaka la tlhaiso ea bopaki bakeng sa mekhahlelo ena.

Mokhoa oa kopo

Bakeng sa repaglinnid, litaelo tsa tšebeliso li khothaletsa ho nka pilisi pele ho lijo. Ngaka e tla khetha tekanyetso e hlokahalang bakeng sa taolo e nepahetseng ea glycemic ho latela liphetho, litekanyetso tsa lefu lena, li-pathologies tsa lilemo, lilemo, karabelo ea 'mele oa motho ka mong ka letsopa.

Ho hlakisa tekanyetso ea bonyane ba kalafo, hoa hlokahala ho laola tsoekere e lapileng le ea ka morao lapeng le ka laboratoring. Ha u lokisa mekhoa ea lithethefatsi, li boetse li tataisoa ke matšoao a hemoglobin ea glycated.

Ho beha leihlo hoa hlokahala ho khetholla ho hloleha ha mantlha le bobeli, ha boemo ba glycemia bo oela ka tlase ho tloaelehileng qalong ea thupelo kapa kamora nako ea pele ea kalafo.

Nako ea ho nka repaglinide ha e thata: metsotso e 15-30 pele ho lijo kapa hang ha motho a qala lijo. Haeba ho kenyelletsoa seneke e le 'ngoe (kapa ho tlotsoa), pilisi e' ngoe e eketsoe (kapa e tlotsoe).

Haeba motho ea nang le lefu la tsoekere ha a e-so fumane lithethefatsi tse fokotsang tsoekere, tekanyo ea letsopa e qalang e lokela ho ba tlase joaloka 0.5 mg pele ho sejo se seng le se seng. Haeba a fetohela ho iphekola ka moriana o mong oa antidiabetes, o ka qala ka 1 mg pele ho lijo tse ling.

Ka kalafo ea tlhokomelo, moriana o khothalletsoang ha o fetele 4 mg pele ho lijo tse kholo. Kakaretso ea letsopa ea letsatsi le letsatsi ha ea lokela ho feta 16 mg.

Ka kalafo e rarahaneng, tekanyo ea repaglinide ha e fetohe, 'me litekanyetso tsa lithethefatsi tse ling li khethoa ho latela' malo oa glucometer le mofuta oa kalafo oa kalafo o fetileng.

Liphetho tse sa rateheng

Har'a lintho tse mpe tse atileng tse hlahisoang ke glinids, hypoglycemia e kotsi haholo. Ha u fana ka litlhare, ngaka e lokela ho tsebisa bakuli matšoao a eona le mekhoa ea bona ea thuso ea pele le boithatelo ho mokuli.

Har'a liketsahalo tse ling tse sa lebelloang:

1. Mathata a amanang le dyspeptic
2. Ho senya morethetho oa metsamao ea maoto,
3. Makhopho a letlalo le ho kula,
4. Ho senyeha ha sebete ka tsela ea keketseho ea transistor tšebetsong ea transaminase,
5. Ho senyeha ho bonahalang ka lebaka la phapang e teng maemong a glycemic.

Liphetoho tsa ho sebelisana le lithethefatsi

Ka tšebeliso e tšoanang ea repaglinide le li-β-blockers, li-inhibitors tsa ACE, chloramphenicol, lino tse tahang, li-inhibitors tsa MAO, li-anticoagulants tse sa tsamaiseng NSAID, probenecid, salicylates, sulfonamides, anabolic steroids, katleho ea letsopa e eketseha.

Tsamaiso e ts'oanang ea li-repaglinide le calcium block blockers, corticosteroids, thiazide diuretics, isoniazid, nicotinic acid ka tekanyetso e se nang litekanyetso, estrogen (e fumanehang ho lithibela-pelehi), psychathomimetics, phenothiazines, phenytoin, lihormone tsa qoqotho li fokotsa matla a glinides.

Thuso ka overdose

Boemo bona bo ka bonoa ke:

• Takatso e sa laoloang
• Mokhathala,
• Letlalo le boreleli,
• Tachycardia,
• Mesifa mesifa
• Mofufutso o mongata
• Ho faola, komisi.

Thuso ho motho ea hlasetsoeng ke matšoao ebile ea tšehetsang. Haeba lefu la tsoekere le tseba, o hloka ho fuoa lik'habohaedreite tse tsoekere (tsoekere, pipi), kamora nakoana, 'mele o tletse ka tsoekere e lokela ho phetoa, kaha ho na le monyetla oa ho khutla.

Haeba mokuli a se na matšoao a letsoalo, tharollo ea glucose (50%) e tsamaisoa ka matla, ho boloka boemo ba glycemic bo kaholimo ho 5.5 mmol / l, lerotholi le kentsoe tharollo ea 10% ea tsoekere. Maemong a tebileng, ho hlokahala sepetlele ka potlako.

Litlhahiso tse ling

Tlhokomelo e ikhethileng (taolo ea ho itima lijo le tsoekere ea ka morao, ts'ebetso ea litho tse fumanehang) ha ho laeloa letsopa ho hlokahala ke batho ba lefu la tsoekere ba nang le lefu la tsoekere le la hepatic. Ba lokela ho tseba hore haeba ho e-na le tlolo ea litekanyetso le mofuta oa lithethefatsi, tšebeliso ea joala, lijo tse nang le khalori e fokolang, ho imeloa ke mesifa, khatello ea maikutlo, ho hlokahala hore o fetole tekanyetso ea repaglinide, hobane maemo a joalo a ka baka hypoglycemia.

Mabapi le litlamorao tse mpe, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le mechini e rarahaneng, e kotsi, ha e sebetsa libakeng tse phahameng, jj.

Ho thibela hypoglycemia, batho ba nang le lefu la tsoekere ba nang le matšoao a fokolang a baetapele, hammoho le ba nang le maemo a joalo ha ba tloaele, ho tlameha ho nkuoe mehato ea ho ba hlokolosi, ho lekola kotsi e ka bang teng le ts'ebetso ea eona.

Repaglinide - analogues

Repaglinide e lokolloa tlasa mabitso a fapaneng a khoebo: NovoNorm, Diclinid, Iglinid, Repodiab.

Ho latela khoutu ea ATX ea boemo ba 4, li-antidiabetesic agents tsa Bayeta liente ka enteatide e sebetsang le Victoza le motsoako o sebetsang oa liraglitide o tsamaisana le eona.

Litsebi tse ling tsa lefu la tsoekere li nka lefu la tsona e le ho se utloisisane ka bomalimabe, ha li lemohe hore lefu lena le bolotsana le ka romella lefats'e le leng ka nako efe kapa efe.

Repaglinide ke moemeli ea matla oa hypoglycemic, ho leka ho itlhalosa le ho e khutlisa ho kotsi ho bophelo bo botle, kaha sethethefatsi se sebetsa kapele, ka lenane le tebileng la li-contraindication le litlamorao. Haeba ho fumaneha hore o na le lefu la tsoekere, o hloka ho phekoloa ka ho teba, ntle le ho lieha ho latela.

Likhetho tsa kalafo ea kalafo ea lefu la tsoekere la mofuta oa 2 li ka fumanoa video.