Hoʻom hoʻomākaukau a Thiazolidinedione

Hōʻike nā Thiazolidinediones i nā hopena ma o ka hoʻemi ʻana i ka pale ʻana i ka insulin. Aia nā 2 thiazolidinediones i loaʻa ma ka mākeke - rosiglitazone (Avandia) a me ka pioglitazone (Actos). ʻO Troglitazone ka mea mua i loko o kāna papa, akā ua hoʻopau ʻia no ka mea ma kahi o ka pīpī paʻū.

Nā hana hana i ka hana. Hoʻonui ka Thiazolidinediones i ka naʻau o ka insulin ma o ka hana ʻana i ka kiko adipose, nā ʻōpū a me nā puʻuwai, kahi e hoʻonui ai i ka hoʻohana o ka glucose a hōʻemi i kona synthes (1,2). ʻAʻole maopopo i ka ʻaoʻao o ka hana.

Loaʻa ʻO Pioglitazone a me rosiglitazone ka like i ka like a i ʻole ka haʻahaʻa haʻahaʻa e like me nā mea āpau hypoglycemic ʻē aʻe. ʻO ka awelika o ka hemoglobin glycosylated i ka wā e lawe ai i ka rosiglitazone e hōʻemi ana i ka 1.2-1,5%, a me ka piʻi ʻana o ka kiʻekiʻe a me ka haʻahaʻa lipoproteins kiʻekiʻe.

Ma muli o ka ʻikepili, hiki ke manaʻo ʻia ʻaʻole i hōʻemi ʻia ka hoʻomaʻemaʻe thiazolidinedione i loko o ka hopena o ka hopena o ka hoʻomaʻamaʻa metformin, akā no ka uku nui a me nā hopena hopena, ʻaʻole i hoʻohana ʻia kēia mau lāʻau lapaʻau no ka mālama mua ʻana i ka maʻi maʻi.

ʻO ka hopena o ka thiazolidinediones ma ke ʻano o ka pūnaehana cardiovascular. Hiki i nā lāʻau hōʻola ma kēia pūʻulu ke hana anti-inflammatory, antithrombotic a me anti-atherogenic hana, akā naʻe, me kēia, nā hōʻike i hōʻike ʻia i ke emi ʻana o nā pilikia o ka maʻi cardiovascular me ka mahalo, a ʻo ka nui o nā hopena hopena e hopohopo nei.

(4,5,6,7) Nā hualoaʻa o ka meta-analyse e hōʻike ana i ka pono o ka mālama ʻana i ka hoʻohana ʻana i ka thiazolidinediones a me rosiglitazone, a hiki i ka ʻike hou i hoʻopaʻa a hōʻole paha i ka ʻike i ka cardiotoxicity.

Eia kekahi, pono e noʻonoʻo i ka hiki o ka ulu ʻana i ka puʻuwai naʻau. I kēia kūlana, ʻaʻole pono e hoʻohana i ka rosiglitazone inā hiki ke hoʻohana i nā lāʻau palekana (metformin, sulfonylureas, insulin).

Nā lipopole. I ka wā o ka maʻi me ka pioglitazone, ke loli nei ka lohi o nā lipid haʻahaʻa haʻahaʻa, ʻoiai me ka lapaʻau me ka rosiglitazone, ka piʻi ʻana o ka neʻe o kēia palaki lipid ma ka awelika o 8-16%. (3)

1. E hoʻonui i ka naʻau o ke kino i ka insulin.

2. E hoʻonui i ka hana o ka insulin i loko o nā beta beta o ka pancreas.

3. E hoʻonui i ka nui o nā mokupuni o ka pancreatic (kahi i hoʻohuihui ʻia ka insulin i nā beta beta).

4. E hoʻonui i ka emi ʻana o ka glycogen ma loko o ke ake (kahi hāmeʻa mālama i hoʻohālikelike ʻia mai ka kō koko koko) a hōʻemi i ka glucoseoneogenesis (ke ʻano o ka glucose mai nā palekala, a me nā kinalā a me nā mea waiwai ʻole'ē aʻe). I ka manawa like, hoʻonui ka hoʻohanaʻana i ka glucose, hoʻokumu a me ka neʻe o ka hoʻokahe koko.

5. Hoʻemi i ka pae o ka triglycerides (lipids, ka mālama momona momona kino).

6. Hiki i ka huli ʻana o ka ovulation i nā wahine me ke ʻano o ke anovulatory i ka manawa o ka premenopause.

7. Hoʻonui i ka hopena hypoglycemic o nā mea āpau hypoglycemic waha, ma ka metformin kūikawā.

Ke kūloko

ʻO ka loaʻa kālā. Hiki i nā thiazolidinediones ke hoʻonui i ka paona. Hoʻokomo kēia hopena i ka maʻi a me ke lōʻihi o ka lāʻau a hiki i ke koʻikoʻi. ka hapa nui ʻana o ke kaupaona ʻana ma muli o ke kaohi ʻana o ke kino i loko o ke kino.

(8) hiki i ke kaupaona ke kaumaha ma muli o ka hoʻonui nui ʻana o ka adipocytes. Noho ka wai a me ka pohō ʻana o ka naʻau. Puhi ka peripheral edema i ka 4-6% o nā mea maʻi e lawe i ka thiazolidinediones (no ka hoʻohālikelike ʻana, ma ka hui plasebo he 1-2% wale nō).

hiki ke hōʻiliʻili o ka wai i ka hiki ʻana i ka naʻau. hiki ke hoʻokuʻi ka wai ma o ka hoʻōla ʻana o ka sodium reabsorption ma o ka epiumal sodium channels, ka hana e hoʻonui ai me ka hoʻoulu ʻana iā RAPP-gamma. (9)

ʻŌnaehana musculoskeletal. Nui nā hōʻailona e hoʻēmi ana nā thiazolidinediones i ka hoʻonaninani ʻana i nā iwi a hoʻonui i ka pōʻino o ka puʻuwai, ʻoi aku hoʻi i nā wahine.

Hepatotoxicity. ʻOiai ʻo rosiglitazone a me pioglitazone i pili me ka hepatotoxicity i nā hoʻokolohua olakino i komo pū me nā poʻe he 5,000, ua hōʻike ʻia nā hihia 4 hepatotoxicity me kēia thiazolidinediones.

ʻEkema Ua hui pū ʻia ka lāʻau Rosiglitazone me ka maʻi eczema.

Edema o ka makula. ʻAʻole maopopo ka ʻike ʻia o kēia ʻano hopena. ʻO ka mea maʻi me ka piʻi nui o ka ulu ʻana i ka edema ʻaʻole pono e loaʻa i ka thiazolidinediones.

Nā Hoʻohui

• 1. Kahi 2 mellitus mākaʻikaʻi, i ka wā e ʻai ai ka lāʻau a me ke ʻano kino i ke ala no ka maʻi.
• 2. Ke hoʻoikaika nei i ka hana a biguanides me ka ʻike ʻole o ka wīwī.

• 1. ʻAno maʻi type 1.
• 2. Dietic ketoacidosis (he keu ka nui o ke koko o nā ketone mau kino), coma.
• 3. ʻōpū a me ka lactation.
• 4. Nā maʻi maʻi māhā a me nā huelo o ka hana paʻa ʻole.
• 5. Haumaha puʻuwai.
• 6. ʻO ka maʻi o ka maʻi lapaʻau.

Thiazolidinediones: nā ʻōlelo i hoʻohana no ka hoʻohana a me ke kiʻina o ka hana

Ke hoʻohana nei nā lāʻau lapaʻau hou i kahi ʻano lāʻau like ʻole e mālama ai i ka maʻi diabetes type 2.

ʻO kekahi o kēia mau pūʻulu he thiazolidinediones, kahi hopena like me ka metformin.

Ua manaʻoʻiʻo ia, i hoʻohālikelike ʻia me ka waiwai ikaika o luna, ʻoi aku ka palekana o thiazolidinediones.

Palapala palapala

1) Nā hopena o ka troglitazone: kahi māpuka hypoglycemic hou i nā poʻe maʻi me ka NIDDM i mālama maikaʻi ʻia e ka lāʻauʻai. Iwamoto Y, Kosaka K, Kuzuya T, Akanuma Y, Shigeta Y, Kaneko T Diabetes Care 1996 Feb, 19 (2): 151-6.

2) E hoʻomaikaʻi i ka hoʻohaʻahaʻa glucose a me ke kū'ē o ka insulin i nā kumumana lema i mālama ʻia me troglitazone. Nolan JJ, Ludvik B, Beerdsen P, Joyce M, Olefsky J N Engl J Med 1994 Nov 3,331 (18): 1188-93.

3) Yki-Jarvinen, H. Kauka Lapaʻau: Thiazolidinediones. N Engl J Med 2004, 351: 1106.

4) Pū pilina ma waena o ka vascular Reactivity a me Lipids ma Mekiko-ʻAmelika me ka Type 2 Diabetes i mālama ʻia me Pioglitazone. Wajcberg E, Sriwijitkamol A, Musi N, Defronzo RA, Cersosimo E J Clin Endocrinol Metab. 2007 Apr, 92 (4): 1256-62. Epub 2007 Jan 23

5) Hoʻohālikelike o ka pioglitazone vs glimepiride ma ka holomua o ka atherosclerosis coronary i nā mea maʻi me ka maʻi type 2: ʻo PERISCOPE ka hoʻāhewa hoʻokolokolo. Nissen SE, Nicholls SJ, Wolski K, Nesto R, Kupfer S, Perez A, Jure H,

6) kahi hoʻāʻo hoʻokolohua kūʻokoʻa ma nā hopena o ka rosiglitazone a me ka metformin ma ke kūleʻa a me ka atherosclerosis subclinical i nā maʻi me nā maʻi maʻi type 2. Stocker DJ, Taylor AJ, Langley RW, Jezior MR, Vigersky RA Am Heart J. 2007 Mar, 153 (3): 445.e1-6.

7) GlaxoSmithKline. E aʻo ʻole. ZM2005 / 00181/01: Ka Hoʻolālā Mea Hoʻohālikelike Kuhi. (Ua helu ʻia ʻo Iune 7, 2007, ma http://ctr.gsk.co.uk/summary/Rosiglitazone/III_CVmodeling.pdf).

8) Troglitazone monotherapy e hoʻomaikaʻi i ka mana glycemic i loko o nā mea maʻi me ka maʻi diabetes mellitus type 2: kahi hana manuahi, hoʻopaʻa noiʻi ʻia. ʻO ka hui aʻo Troglitazone. Fonseca VA, Valiquett TR, Huang SM, Ghazzi MN, Whitcomb RW J Clin Endocrinol Metab 1998 Sep, 83 (9): 3169-76.

9) Hoʻolaha ʻo Thiazolidinediones i ka hoʻōla wai kino ma o ka hoʻolaʻa ʻana o PPARgamma i ka hoʻopihapiha ʻana o ka paʻakai olala o ka ENaC-mediated. Guan Y, Hao C, Cha DR, Rao R, Lu W, Kohan DE, Magnuson MA, Redha R, Zhang Y, Breyer MD Nat Med 2005 Aug, 11 (8): 861-866. Epub 2005 Jul 10.

10) TI - nā hopena hopena o ka maʻi thiazolidinedione. Ke Koke O A Osteoporos Int. 2008 Feb, 19 (2): 129-37. Epub 2007 Sep 28.

11) hopena o ka rosiglitazone ma ke ʻano o ka maʻi maʻamau i ka maʻi ma nā mea maʻi me ka hoʻomanawanui i ka hoʻohaʻahaʻa glucose ʻole a i ʻole ka ʻaihue ʻaihue ʻaihue ʻole. Gerstein HC, Yusuf S, Bosch J, Pogue J, Sheridan P, Dinccag N, Hanefeld M, Hoogwerf B, Laakso M, Mohan V, Shaw J, Zinman B, Holman RR Lancet. 2006 Sep 23,368 (9541): 1096-105

12) Ka Pūnaewele Research DPP. Kāohi i ka maʻi diabetes type 2 me ka troglitazone ma ka papahana hoʻomake ʻana i ka maʻi diabetes. Diabetes 2003, 52 Hoʻohui 1: A58.

Pehea e mālama ʻia ai ka holoholo?

ʻO ke ʻano o ka maʻi maʻi o kēia wā he paʻakikī nā ana.

Hoʻokomo ʻia nā hana Therapeutic i kahi papa lāʻau lapaʻau, ma hope o ka meaʻai paʻa, ka mālama kino ʻana, ka mālama ʻole ʻana i ka lāʻau lapaʻau a me ka hoʻohana ʻana i nā ʻano lāʻau lapaʻau maʻamau.

ʻO ka mālamaʻana i ka maʻi diabetes e hoʻohana i nā lāʻau lapaʻau kūikawā e hoʻokō i kekahi pahuhopu therapeutic.

ʻO kēia mau pahuhopu mālama ʻia:

• ka mālama ʻana i ka nui o ka insulin o ka nui i ka pae i koi ʻia,
• ka hoʻohanohano ʻana o ka nui o ka glucose i loko o ke koko,
• he mea pilikia i ka hoʻonui hou ʻana o ke kaʻina pili,
• ka pani ʻana i nā hōʻike o nā hoʻopiʻi a me nā hopena maikaʻi ʻole.

Hoʻopili ka papa lāʻau therapeutic i ka hoʻohana ʻia ʻana o nā pūʻulu o kēia mau lāʻau.

1. Hoʻomākaukau Sulfonylurea, kahi e hana ai i ka hapaʻumi mau hapa kaila o nā lāʻau lapaʻau āpau. Hoʻopili maikaʻi kēia mau papa i ka pale ʻana i ka insulin.
2. ʻO Biguanides nā lāʻau me kahi mea ikaika e like me ka metformin. Loaʻa i ka māhele i ka hopena maikaʻi i ka pohō kaumaha, a kōkua pū i ka hoʻemi ʻana i ke kō koko. Ma ke ʻano he kānāwai, ʻaʻole i hoʻohana ʻia ma ka hihia o nā maʻi like ʻole a me ka hana o ka puʻuwai, ʻoiai e hōʻuluʻulu koke ʻia i loko o kēia mau kino.
3. Hoʻohana ka poʻe Alpha-glycosidase prophylactically i mea e pale ai i ka hoʻomohala ʻana i ka maʻi type 2. ʻO ka pōmaikaʻi nui o nā lāʻau lapaʻau o kēia hui, ʻaʻole lākou e alakaʻi i ka hōʻike ʻana o ka hypoglycemia. ʻO ka lāʻau i hoʻōla ʻia ka hopena he hopena maikaʻi ma ka maʻamau o ka paona, kaomi inā ukali ka mālama ʻana i nā lāʻauʻai.
4. Hiki ke hoʻohana ʻia nā Thiazolidinediones ma ke ʻano nui no ka mālama ʻana i nā pathology a i ʻole me nā lāʻau lapaʻau e hoʻohaʻahaʻa ana. ʻO ka hopena nui o nā papa i ka hoʻonui ʻana i ke ʻano o ka naʻau i ka insulin, a laila e pale ai i ka pale ʻana. ʻAʻole hoʻohana ʻia nā lāʻau lapaʻau i ka hoʻomohala ʻana o ke ʻano maʻi mellitus type 1, no ka mea hiki wale iā lākou ke hana i ke kaona o ka insulin, ka mea i kūkulu ʻia e ka pancreas.

Hoʻohuiʻia, hoʻohana ʻia nā meglitinides - nā lāʻau lapaʻau e hoʻonui ai i ka huna ʻana i ka insulin, no laila e hoʻopiʻi ana i nā ʻāpana beta pancreatic.

ʻO ka emi ʻana o nā pae i ka glucose i nānā ʻia he ʻumikumamālima mau minuke ma hope o ka lawe ʻana i ka paila.

Ka hopena o nā thiazolidinediones ma ke kino?

Hoʻokomo ʻia nā lāʻau lapaʻau mai ka pūʻulu o thiazolidinediones e kūlohelohe i ka pale ʻana i ka insulin.

Ke manaʻoʻiʻo ia hiki i kēlā mau penikala ke pale i ka hiki o ka hoʻomohala ʻana i ke ʻano maʻi type 2.

Ke hōʻike nei ka lāʻau lapaʻau hou i ʻelua mau lāʻau lapaʻau nui mai kēia hui - Rosiglitazone a me Pioglitazone.

Nā hopena nui o nā lāʻau lapaʻau ma ke kino:

• e hoʻonui i ka naʻau maʻi i ka insulin,
• Hoʻonui i ka synthesis i hoʻonui ʻia i loko o nā pupu beta pancreatic,
• hoʻonui i ka hopena o ka metformin i ka hui hoʻohui.

Hoʻohana ʻia ka hoʻomākaukau ʻana mai ka pūʻulu thiazolidinediones i kēia mau pilikia:

1. No ka mālamaʻana a me ka pale ʻana i ka maʻi maʻi type 2.
2. ʻO ka hoʻākālo koʻikoʻi i ka wā o ka mālama ʻana i nā meaʻai no ka maʻi maʻi a hoʻomaʻamaʻa ʻia ka hoʻomaʻamaʻa.
3. No ka hoʻonui ʻana i ka hopena o nā lāʻau lapaʻau mai ka pūʻulu biguanide, inā ʻaʻole hōʻike iki ka mea hope.

Hiki ke hōʻike ʻia nā lāʻau lapaʻau thiazolidinedione hou i nā ʻano like ʻole, i ke ʻano o ka hoʻomohala ʻana o ka pathology - ʻumikumamālima, kanakolukumamālima mau milligrams o ka hana ikaika. Hoʻoikaika ʻia ka papa o ka lapaʻau e hoʻomaka me kahi liʻiliʻi haʻahaʻa a lawe ʻia i hoʻokahi manawa i ka lā. Ma hope o ʻekolu mahina, inā pono, e hoʻonui i ka dosis.

ʻO ka pinepine, ʻo ka lāʻau lapaʻau e hoʻohana ʻia e hoʻohaʻahaʻa i ka glucose koko. Eia kekahi, ma kahi hana lapaʻau, he mea maʻamau ia e hoʻokaʻawale i nā mea maʻi i lawe i nā pōpoki i ka "pane" a me ka "pane ʻole" i ka hopena o ka lāʻau.

Ke manaʻoʻiʻo ia e hoʻemi iki ʻia ka hopena o ka hoʻohanaʻana o thiazolidinediones ma mua o ka pauʻa o nā honi haʻahaʻa o nā hui ʻē aʻe.

Hoʻom hoʻomākaukau a Thiazolidinedione

ʻO Troglitazone (Rezulin) ka lāʻau o ka hanauna mua o kēia hui. Hoʻomau ʻia ʻo ia mai ke kūʻai aku ʻana, ʻoiai he hopena maikaʻi loa kona hopena i ka ate.

ʻO Rosiglitazone (Avandia) kahi lāʻau lapaʻau hanana kolu i kēia pūʻulu. Ua paʻa i ka hoʻohana ʻia ma ka 2010 (ua pāpā ʻia i loko o ka European Union) ma hope o kona hōʻoia ʻia ʻana e hoʻonui i ka nui o ka maʻi o ka maʻi maʻi.

ʻO ka hana o ka hana pioglitazone

ʻO ka hana o ka pioglitazone e hoʻopili i kahi mea hōʻiliʻili PPAR-gamma kūikawā, aia i ka sela o ka paena. No laila, ʻo ka lāʻau lapaʻau e hoʻopilikia i ka hana o nā pūlima e pili ana i ka hoʻoili ʻana o ka glucose. Pono ka ate, ma lalo o kona mana, e hoʻoulu nui ʻia. I ka manawa like, hoʻonui ka naʻau i ka insulin.

Pono e ʻike: he aha ke kū'ē o ka insulin

Hoʻopau maoli kēia i nā momona, nā ʻāʻī a me nā pili o ke ake. A laila, aia ka emi o ka wikiwiki o ka glucose glucose glucose a me ka loaʻa o ke kaona glucose postprandial.

Hoʻohana ikaika

Eia kekahi, ua hōʻike ʻia he lāʻau lapaʻau kekahi mau mea pōmaikaʻi hou.

• Hoemi ke koko
• Hoʻopilikia i ka pae o ka cholesterol (hoʻonui i ke alo o ka "cholesterol maikaʻi", ʻo ia hoʻi, HDL, a ʻaʻole e hoʻonui i ka "kino kino" - LDL),
• Mālama i ka hoʻokumu a me ka ulu ʻana o ka atherosclerosis,
• Hoʻemi i ka hōʻeha o ka maʻi naʻau (e.g., hōʻeha ka naʻau, ka ʻoka).

E heluhelu hou: E mālama ʻo Jardins i ka naʻau

ʻO nā pioglitazone e kuhikuhi ʻia

Hiki ke hoʻohana ʻia Pioglitazone ma ke ʻano he lāʻau ʻai hoʻokahi, i.e. monotherapy. Eia kekahi, inā ʻoe i ka maʻi mellitus type 2, ʻo kou mau loli i ke ola e hāʻawi i nā hopena i manaʻo ʻia a aia nō nā contraindications to metformin, ʻo kona palaka maikaʻi ʻole a me nā hopena hopena paha.

Hiki ke hoʻohana ʻia ka pioglitazone me ka hoʻohui i nā lāʻau antidiabetic e like me ka laʻana, ka acarbose) a me ka metformin inā ʻaʻole i lawe ʻia nā hana ʻē i ka kūleʻa.

Hiki ke hoʻohana ʻia ʻo Pioglitazone me ka insulin, e ʻike pū i nā poʻe e kūleʻa ke kino i ka metformin.

E heluhelu hou: Pehea e lawe ai i ka metformin

Pehea e lawe ai i ka pioglitazone

Pono ka lāʻau lapaʻau ʻia i hoʻokahi manawa i ka lā, ma ke ʻano, i ka manawa paʻa. Hiki i kēia ke hana ma mua a ma hope o ka ʻai, no ka mea ʻaʻole i pili ka meaʻai i ka hoʻopili ʻana o ka lāʻau. ʻO ka maʻamau, hoʻomaka ka hoʻomaʻamaʻa me ka liʻiliʻi haʻahaʻa. I nā wahi i loaʻa ʻole ka hopena o ka mālama ʻana, hiki ke hoʻonui iki ʻia.

Hoʻohana ʻia ka hopena o ka lāʻau i nā hihia i kahi e pono ai e mālama i ka maʻi diabetes type 2, akā ʻaʻole hiki ke hoʻohana ʻia ka metformin, monotherapy me hoʻokahi lāʻau lapaʻau i ʻae ʻia.

I ka ʻoi aʻe o ka pioglitazone e hōʻemi i ka glycemia postprandial, ka glucose o ka plasma a hoʻopaʻa hou i ka hemoglobin glycated, he hopena hou nō hoʻi ia ma ke kaʻe o ke koko a me ka kolamu koko. Eia kekahi, ʻaʻole ia e hoʻomaka i nā anomalies.

Nā hopena hopena

ʻO nā hopena ʻokoʻa e kū pū me ka terapi pioglitazone e komo ana i loko:

• Hoʻonui ka ʻike wai i loko o ke kino (ʻoi aku ka hoʻohana ʻia me ka insulin)
• I ka hoʻonui ʻia ʻana o ka hana palupalu, kahi i hoʻopiʻi ʻia me nā hōʻeha ʻana,
• ʻO nā maʻi hou o nā mea hanu maʻamau
• ʻO ka loaʻa kālā.
• ʻO ka haunaele hiamoe.
• Polōpiopio.

ʻO ka lawe ʻana i ka lāʻau lapaʻau ka mea e hoʻonui i ka hopena o ka macular edema (ʻo ke ʻano mua ka mea hōʻino i ka acuity ʻike, pono hoʻi e hōʻike koke ʻia i ka ophthalmologist) a me ka hopena o ka hoʻomohala ʻana i ka maʻi maʻi kīnā.

ʻAʻole kēia lāʻau lāʻau i ka hypoglycemia, akā hoʻonui i ka pilikia o kona hōʻeha ʻana i ka wā i hoʻohana ʻia me nā lāʻau lapaʻau i loaʻa mai ka insulin a i ka sulfonylurea paha.

E heluhelu hou: i nā lāʻau lapaʻau hou no ka mālama ʻana i ka maʻi diabetes mellitus type 2 (dulaglutide)

- nā kīpaha palemona (3) - nā pā o ka pahu paʻi. 10 pcs. - nā kīpaha palemona (6) - nā pākeke o ka pahu kāleka. - nā kīʻaha polymer (1) - nā ʻeke pepa.

- nā pahu huki (1) - nā ʻeke pepa.

Ka hana lāʻau lapaʻau

Kēia waha hypoglycemic aihue, ke kumupaʻa o ka series thiazolidinedione. ʻO kahi agonist ikaika mana koho o nā gamma receptors i hana ʻia e ka proliferator peroxisome (PPAR-gamma). Loaʻa ka poʻe hoʻonaʻauao PPAR gamma i ka adipose, muscle muscle a i ka puʻuwai.

Hoʻololi i ka hoʻonaninani kūloko o PPAR-gamma ka hoʻololi i ka helu o ka nui o nā huaʻehā o ka insulin e pili ana i ka mālama glucose a me ka hana lipid metabolism. Hoʻemi i ka paleʻana o ka insulin i nā huakaʻi peripheral a me nā puʻuwai, ma muli o kēia e hoʻonui ai i ka ʻai ʻana i nā glucose a hilinaʻi i ka insulin a me kahi hoʻohaʻahaʻa i ka hana glucose i loko o ka ate.

ʻAʻole i like me derivatives sulfonylurea, ʻaʻole i hoʻoulu ʻia ka pioglitazone i ka huna ʻia o ka insulin e nā cell beta pancreatic.

Ma ke ʻano 2 diabetes mellitus (ʻaʻole i paulele-insulin), he hōʻemi i ka kū ʻana o ka insulin i lalo o ke ʻano o ka pioglitazone alakaʻi i kahi kaohi o ka glucose o ka toto, ke emi ʻana i ka insulin plasma a me ka hemoglobin A1c (hemoglobin glycated, HbA1c).

Ma ke ʻano 2 diabetes mellitus (ʻaʻole i hilinaʻi-insulin) me ka lipid metabolism impostment e pili ana me ka hoʻohana ʻana o ka pioglitazone, aia ka emi ma ke pae o TG a me ka piʻi ʻana o ka pae o ka HDL. I ka manawa like, ʻaʻole e loli ka nui o ka LDL a me ka kolamu holoʻokoʻa i kēia mau maʻi.

Lapaʻau lāʻau

Ma hope o ka nānā ʻana i ka ʻōpū ʻole, ua ʻike ʻia ka pioglitazone i loko o ke koko koko ma hope o 30 mau minuke. Loaʻa ka Cmax i ka plasma ma hope o 2 mau hola.I ka ʻai ʻana, liʻiliʻi ka minamina i ka manawa e hōʻea ai i Cmax a hiki i 3-4 mau hola, akā ʻaʻole i loli ka pae o ka pale ʻana.

Ma hope o ka lawe ʻana i kahi helu hoʻokahi, ʻo ka mea i ʻike ʻia Vd o ka pioglitazone wai 0.63 ± 0.41 l / kg. Hoʻohālikelike ʻia i nā protein serum o ke kanaka, ʻo ka mea nui me ka albumin, ʻoi aku ma mua o 99%, paʻa i nā protein serum e haʻi iki. ʻO nā mea hoʻokūkū o ka pioglitazone M-III a me M-IV e pili pū kekahi me nā serum albumin - ʻoi aku ma mua o 98%.

Hoʻomili nui ʻo Pioglitazone i loko o ka pēpē ma ka hydroxylation a me ka maʻi oxidation. Hōʻike ka Metabolites M-II, M-IV (hydroxy derivatives o ka pioglitazone) a me M-III (keto derivatives o ka pioglitazone) hōʻike i ka hana lāʻau lapaʻau i nā holoholona holoholona o ka maʻi type o ka maʻi 2. ʻO ka Metabolites ke hoʻohuli pū kekahi i nā conjugates o nā glucuronic aiʻole acid sulfuric.

ʻO ka mea hoʻokūkū o ka pioglitazone i ka lewa e hele ana me ka komo o ka isoenzymes CYP2C8 a me CYP3A4.

ʻO T1 / 2 o ka pioglitazone i loli ʻole he 3-7 mau hola, ka nui pioglitazone (pioglitazone a me nā metabolite ikaika) ʻo 16-24 mau hola.ʻO ke kala ʻana o ka pioglitazone ʻo 5-7 l / h.

Ma hope o ka hoʻoponopono waha, ma kahi o 15-30% o ka nui o ka pioglitazone e loaʻa i loko o ka urine. ʻO ka liʻiliʻi o ka pioglitazone i hoʻopili ʻia e nā keiki, ma ka nui o ke ʻano o nā metabolites a me kā lākou conjugates. Manaʻo ia ua hoʻohālikelike ʻia, i ka hapanui o ke kauā i hoʻopili ʻia i loko o ka bile, i loli ʻole a me ka ʻano o nā metabolites, a hoʻihoʻi ʻia mai ke kino me nā feces.

Hoʻohui ka ʻike o ka pioglitazone a me nā metabolite ikaika i ka serum koko i kahi kiʻekiʻe kiʻekiʻe 24 mau hola ma hope o ke ʻano hoʻokahi o ka lawelawe ʻana i kēlā me kēia lā.

ʻO ka maʻi diabetes mellitus type 2 (non-insulin dependant).

Hoʻohui nūhou

Ke hoʻohana ʻia nei i kahi derivative o thiazolidinedione i ka manawa like me ka kūlohelohe waha, ua hoʻemi ʻia ka nui o ke kaila o ka ethinyl estradiol a me ka norethindrone i ka plasma e nānā ana ma kahi o 30%. No laila, me ka hoʻohana pinepine ʻana o ka pioglitazone a me nā mea hoʻohālikelike waha, hiki iā ia ke hōʻemi i ka hopena o nā mea hoʻohālikelike.

Hoʻopili ʻia ʻo Ketoconazole i ka hana a ka vitro metabolism o ka pioglitazone.

Nā ʻōlelo kikoʻī

ʻAʻole pono e hoʻohana ʻo Pioglitazone ma mua o ka hōʻike ʻana i nā hōʻike lapaʻau o nā maʻi o ka maʻa i ka hana ikaika a i ʻole ka hoʻonui ʻana i ka hana ALT 2.5 mau manawa ma mua o VGN. Me kahi hana maʻalahi e hoʻonui ai i nā enzymes o ati (ALT ma lalo o 2.

5 mau manawa ʻoi aku ka nui o VGN) ma mua o ka manawa o ka mālama ʻana me nā maʻi pioglitazone e nānā pono i ke kumu o ka hoʻonui. Me ka hoʻonui haʻahaʻa o ka hana enzyme hana, pono e hoʻomaka ʻia ka mālama me ka akahele a hoʻomau ʻia paha.

I kēia hihia, ʻoi aku ka nānā pinepine ʻana o ka kiʻi lapaʻau a me ke aʻo ʻana i ka pae o ka hana o nā huina o nā ate.

I ka loaʻa o ka hoʻonui i ka hana o nā transaminases i ka serum koko (ALT> 2.

No 5 mau manawa ʻoi aku ka nui ma mua o VGN) e nānā pinepine ʻia a hiki i ka hoʻi ʻana i ke kiʻekiʻe a i ʻole nā ​​hōʻailona i nānā ʻia ma mua o ka mālama ʻana.

Inā he hana 3 ALT i ka manawa he 3 i ʻoi aku ma mua o VGN, a laila e hoʻokō pono ʻia kahi hōʻike ʻelua e hoʻoholo i ka hana o ALT. Inā noho mau ka hana ALT ma kahi pae o 3 mau manawa> e ʻoki ʻia ʻo VGN pioglitazone.

I ka wā o ka hoʻōla ʻana, inā he kānalua ka hoʻomohala ʻana i ka hana o ka ʻōpū o ka lēwa (ke ʻano o ke ʻano nausea, ka luaʻi, ka ʻeha o ka ʻōpū, nā luhi, ka nele o ka makemake, ka urineʻeleʻele), nā ʻōnaehana hana pili pono e hoʻoholo. ʻO ka hoʻoholo e pili ana i ka hoʻomau ʻana o ka lāʻau pioglitazone e pono e lawe i ke kumu o nā ikehu haukapila, me ka mālama ʻana i nā ʻōnaehana ʻalani. I ka hihia o ka jaundice, pono e haʻalele i ka pioglitazone.

Me ka mālama aka, pono e hoʻohana ʻia ka pioglitazone i nā maʻi me ka edema.

ʻO ka hoʻomohala ʻana o ka anemia, kahi hoʻemi i ka hemoglobin a me kahi hoʻohaʻahaʻa i ka hematocrit hiki ke hoʻopili me ka piʻi ʻana o ka nui o ka plasma a ʻaʻole i hōʻike i nā hopena hematological koʻikoʻi.

Inā pono, pono ka hoʻohana pinepine ʻana o ka ketoconazole e mālama pono i ka pae o ka glycemia.

ʻO nā hihia i hala ʻole o ka hoʻonui iki ʻana i ka manawa o ka hana CPK i kuhihewa ʻia i ka hope o ka hoʻohana ʻana i ka pioglitazone, ʻaʻohe hopena o ka maʻi. ʻAʻole maopopo ka pili ʻana o kēia mau ʻano me ka pioglitazone.

ʻO nā kumukūʻai o ka bilirubin, AST, ALT, ka phosphatase alkaline a me GGT i hōʻemi i ka wā o ka hoʻokolokolo ma ka hopena o ka lapaʻau pioglitazone hoʻohālikelike me nā hōʻailona like ma mua o ka mālama ʻana.

Ma mua o ka hoʻomaka ʻana i ka mālama ʻana a ma ka makahiki mua o ka mālama ʻana (i kēlā me kēia 2 mau mahina) a laila no ka manawa maʻamau, ʻike ʻia ka hana ALT.

I nā hoʻokolohua hoʻokolohua ʻaʻole i hōʻike ʻia ka pioglitazone e mutagenic.

ʻAʻole hoʻohana ʻia ka hoʻohana ʻana o ka pioglitazone i nā keiki.

ʻŌpū a me ka lactation

Pioglitazone contraindicated i ka wā hāpai a me ka lactation.

I ka poʻe maʻi me ka pale ʻana i ka insulin a me ka pōkole anovulatory i ka manawa premenopausal, mālama ʻia me ka thiazolidinediones, me ka pioglitazone, hiki i ka ovulation. Hoʻonui kēia i ka pilikia o ka hapai inā ʻaʻole i hoʻohana pono ʻia ka contraception.

I nā hoʻokolohua hoʻokolohua ua hōʻike ʻia i nā holoholona i loaʻa i ka pioglitazone he hopena teratogenic ʻaʻole i hoʻopōʻino i ka ulu.

Me ka hana pūpū hemahema

ʻAʻole pono e hoʻohana ʻo Pioglitazone ma mua o ka hōʻike ʻana i nā hōʻike lapaʻau o nā maʻi o ka maʻa i ka hana ikaika a i ʻole ka hoʻonui ʻana i ka hana ALT 2.5 mau manawa ma mua o VGN. Me kahi hana maʻalahi e hoʻonui ai i nā enzymes o ati (ALT ma lalo o 2.

5 mau manawa ʻoi aku ka nui o VGN) ma mua o ka manawa o ka mālama ʻana me nā maʻi pioglitazone e nānā pono i ke kumu o ka hoʻonui. Me ka hoʻonui haʻahaʻa o ka hana enzyme hana, pono e hoʻomaka ʻia ka mālama me ka akahele a hoʻomau ʻia paha.

I kēia hihia, ʻoi aku ka nānā pinepine ʻana o ka kiʻi lapaʻau a me ke aʻo ʻana i ka pae o ka hana o nā huina o nā ate.

I ka loaʻa o ka hoʻonui i ka hana o nā transaminases i ka serum koko (ALT> 2.

No 5 mau manawa ʻoi aku ka nui ma mua o VGN) e nānā pinepine ʻia a hiki i ka hoʻi ʻana i ke kiʻekiʻe a i ʻole nā ​​hōʻailona i nānā ʻia ma mua o ka mālama ʻana.

Inā he hana 3 ALT i ka manawa he 3 i ʻoi aku ma mua o VGN, a laila e hoʻokō pono ʻia kahi hōʻike ʻelua e hoʻoholo i ka hana o ALT. Inā noho mau ka hana ALT ma kahi pae o 3 mau manawa> e ʻoki ʻia ʻo VGN pioglitazone.

I ka wā o ka hoʻōla ʻana, inā he kānalua ka hoʻomohala ʻana i ka hana o ka ʻōpū o ka lēwa (ke ʻano o ke ʻano nausea, ka luaʻi, ka ʻeha o ka ʻōpū, nā luhi, ka nele o ka makemake, ka urineʻeleʻele), nā ʻōnaehana hana pili pono e hoʻoholo. ʻO ka hoʻoholo e pili ana i ka hoʻomau ʻana o ka lāʻau pioglitazone e pono e lawe i ke kumu o nā ikehu haukapila, me ka mālama ʻana i nā ʻōnaehana ʻalani. I ka hihia o ka jaundice, pono e haʻalele i ka pioglitazone.

Kuhi ʻia ka wehewehe ʻana i ka lāʻau ASTROZON ma nā mana i ʻae ʻia no ka hoʻohana a ʻae ʻia e ka mea hana.

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Hoʻomākaukau Thiazolidinedione - nā hiʻohiʻona a me nā hiʻohiʻona noi

Hāʻawi i nā pathogenesis o ke ʻano maʻi type 2, ua kuhikuhi ʻia nā mea maʻi i nā lāʻau hypoglycemic o nā hopena like ʻole. Hoʻowalewale kekahi i ka hana ʻana o ka insulin e nā cell pancreatic, ʻoiai ke hoʻoponopono nei kekahi i ka kū i ka insulin.

ʻO Thiazolidinediones nā lālā o nā lāʻau lapaʻau hope loa.

Nā hiʻohiʻona o thiazolidinediones

ʻO Thiazolidinediones, i nā huaʻōlelo glitazones kekahi ʻano o nā lāʻau o ke koena haʻahaʻa i makemake e hoʻonui i ka hopena olakino o ka insulin. No ka mālama ʻana i ka maʻi mellitus no ka hoʻomaka ʻana no ka maʻi maʻamau - mai ka makahiki 1996. Hoʻokuʻu loa ʻia e like me ka papa kuhikuhi.

ʻO Glitazones, ma ka hana o ka hana hypoglycemic he hopena kūpono ma ka ʻōnaehana cardiovascular. ʻO ka hana aʻe i nānā ʻia: antithrombotic, antiatherogenic, anti-inflammatory. Ke lawe nei i ka thiazolidinediones, e emi ana ka pae o ka hemoglobin glycated ma ka awelika o 1.5%, a hoʻonui ka kiʻekiʻe o ka HDL.

ʻO ka hopena me nā lāʻau lapaʻau o kēia papaʻaina ʻaʻole mea emi iki ma mua o ka lāʻau me ka Metformin. Akā ʻaʻole lākou i hoʻohana i ka hana mua me ka maʻi diabetes type 2. ʻO kēia ke kumu o ka paʻakikī o nā hopena ʻaoʻao a me ke kumukūʻai kiʻekiʻe. I kēia lā, hoʻohana nā glitazones e hoʻohaʻahaʻa i ka glycemia me nā derivatives a me ka metformin. Hiki iā lākou ke hoʻokaʻawale ʻia a me nā mea hoʻokaʻawale i kēlā me kēia lāʻau lapaʻau, a i hui pū ʻia.

Hoʻomaopopo! Aia he hōʻike no ka lawe ʻana i nā glitazones i ka poʻe me ka prediabetes i hōʻemi ʻia ka hopena o ka hoʻomohala ʻana i ka maʻi ma ka 50%. E like me nā hualoaʻa o ka noi ʻana, ua loaʻa i ka lawe ʻana i ka thiazolidinediones i hoʻokuʻu i ka hoʻomohala ʻana o ka maʻi ma ka 1,5 mau makahiki. Akā ma hope o ka hoʻokuʻu ʻana o nā lāʻau lapaʻau o kēia papa, ua like like nā hopena.

I waena o nā hiʻohiʻona o nā lāʻau lapaʻau ke kūpono a maikaʻi ʻole:

• hoʻonui i ke kaupaona kino ma 2 kg ma ka awelika,
• ʻO kahi papa nui o nā hopena pili
• Hoʻomaikaʻi i ka ʻōlelo lipid
• Hoʻomaʻa maikaʻi ka hopena i ka pale ʻana i ka insulin
• ka hana haʻahaʻa haʻahaʻa haʻahaʻa hoʻohālikelike i ka metformin, sulfonylurea derivatives,
• kahe koko koko
• ho'ēmi i nā mea e pili ana i ka hoʻomohala ʻana o ka atherosclerosis,
• kaomi wai, a ma muli o ia, ʻo ka piʻi ʻana o nā pilikia o ka hoʻopiʻi ʻana o ka naʻau,
• hoʻemi i ka kūloko o ka iwi, hoʻonui i ka nui o ka puʻuwai,
• hepatotoxicity.

Nā hōʻailona a me nā contraindications

Thiazolidinediones e kuhikuhi ʻia no ka non-insulin-dependant type (type 2 diabetes):

• like monotherapy no kēlā poʻe maʻi e kāohi i ke kiʻekiʻe o ka glycemia me ka lāʻau ʻole (kaʻai a me ka hana kino),
• ʻoiai, he mau mea ʻelua e hui pū ana me ka hoʻomākaukau ʻana o ka sulfonylurea,
• ʻoi aku ka lawelawe ʻana i ka metformin no ka ʻoluʻolu o ka glycemic control,
• me he lā triple lapaʻau o "glitazone + metformin + sulfonylurea",
• hui me ka insulin
• hui me insulin a me metformin.

I waena o nā contraindications i ka lawe ʻana i nā lāʻau lapaʻau:

• holomua,
• hapai / lactation
• makahiki i 18 makahiki
• huni kūlohelohe - koʻikoʻi a me ke kaumaha
• hōʻeha paʻa ka naʻau
• pilikia nui ʻole ʻo ia.

Hoʻolohe ʻAʻole kuhikuhi ʻia ʻo Thiazolidinediones no nā maʻi me nā maʻi maʻi type 1.

ka hōʻiliʻili o nā lāʻau lapaʻau o ka hui thiazolidinedione:

Dosage, ʻano o ka hoʻokele

Lawe ʻia nā Glitazones me ka ʻole e mālama i ka meaʻai. ʻAʻole hana ʻia ka hoʻoponopono ʻia ʻana no ka poʻe ʻelemakule me nā kekeʻe liʻiliʻi i loko o ke akea. Kahi ʻia ka ʻaoʻao o nā mea maʻi e kuhikuhi i kahi haʻahaʻa o kēlā lā i kēia lā i ka lāʻau. Hoʻoholo ʻia ka Doseage e ke kauka hoʻokahi.

Hoʻomaka ka hoʻomaka ʻana o nā lāʻau me kahi hōʻemi haʻahaʻa haʻahaʻa. Inā kūpono, hoʻonui ʻia i nā kukū ʻana ma luna o ka lāʻau lapaʻau. Ke hui pū ʻia me ka insulin, e loli ʻole kona ʻano o ke ʻano me ka ʻole o nā hōʻike o nā kūlana hypoglycemic.

Thiazolidinedione ʻAuhala Kauka

Loaʻa nā ʻelua inoa o glitazone ma ka mākeke lāʻau i kēia lā - rosiglitazone a me pioglitazone. ʻO ka mea mua i ka hui he troglitazone - ua hoʻopau koke ʻia ia ma muli o ka hoʻomohala ʻana o ka hōʻeha kino o ka pūpū.

Ke loaʻa nei nā lāʻau lapaʻau e pili ana i ka rosiglitazone:

• 4 mg avandia - Sepania,
• 4 mg Diagnitazone - Ukraine,
• Roglit ma ka 2 mg lāua ʻo 4 mg - ʻo Hūlani.

ʻO nā lāʻau lapaʻau Piogitazone e loaʻa:

• Glutazone 15 mg, 30 mg, 45 mg - Ukraine,
• Nilgar 15 mg, 30 mg - India,
• Dropia-Sanovel 15 mg, 30 mg - Turkey,
• Pioglar 15 mg, 30 mg - India,
• Pyosis 15 mg lāuaʻo 30 mg - India.

Hoʻopili me nā lāʻau lapaʻau ʻē aʻe

1. Rosiglitazone. ^ E Ha yM. ʻAʻole pili ka hoʻohana ʻana i ka waiʻona i ka mana glycemic. ʻAʻohe ʻano nui o ka hui me nā tablet contaceptives, Nifedipine, Digoxin, Warfarin.
2. Pioglitazone. ^ E Ha yM. Ke hoʻohui a me ka rifampicin, hoʻemi ʻia ka hopena o ka pioglitazone. Malia paha kahi emi iki o ka hopena o ka contraception aʻo ka lawe ʻana i nā mea papa papa. Ke hoʻohana ʻana i ka ketoconazole, pono nui ka mālama glycemic.

ʻAʻole nā ​​Thiazolidinediones e hōʻemi wale i nā pae koko, akā hoʻopilikia maikaʻi hoʻi i ka ʻōnaehana cardiovascular. Ma waho aʻe o nā pono, loaʻa iā lākou kahi nui o nā hiʻohiʻona maikaʻi, ʻo ia ka mea maʻamau ka nui o ka hoʻokumu ʻana o ka puʻuwai naʻau a me ka emi ʻana o ka hana ʻana o ka iwi.

Hoʻohana pinepine ʻia lākou i loko o ka maʻi paʻakikī, ka hoʻohana ʻana i thiazolidinediones no ka pale ʻana i ka hoʻomohala ʻia o ka maʻi e pono ai ka noiʻi hou aku.

Nā Manaʻo ʻ Otherlelo ʻē aʻe

ʻO nā lāʻau kākāola

Nā hōʻailona no ka hoʻohana ʻana
Hoʻohana ʻia lākou e hoʻohana ʻia no ka type 2 diabetes mellitus me ka mālama ʻole o ka mālama ʻana i ka meaʻai, ʻoiai e like me ka monotherapy a i hui pū ʻia me nā lāʻau haʻalulu haʻahaʻa o nā hui ʻē aʻe.
ʻO ka hana ʻana i nā lāʻau lapaʻau o kēia hui e huli i ka hoʻonui ʻana i ka hoʻololi ʻana i nā kinipona kiko i ka insulin. No laila, hōʻemi lākou i ka pale ʻana i ka insulin.

I kēia mau lāʻau lapaʻau hou, ʻelua mau lāʻau o kēia pūʻulu: Rosiglitazone a me Pioglitazone.

ʻO ka hana o kēia mau lāʻau ka mea like: e hōʻemi ana lākou i ka pale kūʻana o ka insulin e ka hoʻonui ʻana i ka synthesis o nā pūnaewele transporter glucose.
ʻO kā lākou hana he hiki wale nō ke loaʻa iā ʻoe iho insulin.

Eia kekahi, hoʻohaʻahaʻa lākou i ka pae o nā triglycerides a me nā momona momona i loko o ke koko.

Pharmacokinetics: Hoʻokomo koke nā lāʻau i ka gastrointestinal tract. Loaʻa ka ʻike kiʻekiʻe ma ke koko i nā hola he 1-3 ma hope o ka hoʻokele ʻana (rosiglitazone ma hope o 1-2 mau hola, pioglitazone ma hope o he 2 mau hola).

Hoʻopili i ka puʻuwai. Hana nā Pioglitazone i nā metabolites ikaika, hāʻawi kēia i kahi hopena lōʻihi.

Nā maʻi hoʻohālikelike 1 ka maʻi mellitus mika. ʻO nā maʻi a me ka lactation. ʻO nā maʻi maʻi i ka wā o ka exacerbation. Nā pae ma ke kiʻekiʻe o ka ALT ma mua o nā manawa he 2 mau manawa a keu paha.

Aia ma lalo o ka makahiki 18 i lalo iho.

ʻO nā hopena hopena Ua hōʻike ʻia nā hihia āpau o ka hoʻonui ʻana i ke kiʻekiʻe o ALT, me ka hoʻomohala ʻana i ka maikaʻi o ke akeʻa a me ka hepatitis me ka hoʻohana ʻana i ka thiazolidinediones.

No laila, pono e loiloi i ka hana lūlū ma mua o ka lawe i ka lāʻau lapaʻau a hana i ka nānā wā maʻamau i ka wā e lawe ai i ka thiazolidinediones.

ʻO ka lawe ʻana i nā thiazolidinediones hiki i ka hāʻawi kālā. Hana ʻia kēia me monotherapy, a me ka hoʻohui pū ʻana o ka thiazolidinediones me nā lāʻau lapaʻau'ē aʻe. ʻAʻole maopopo i ke kumu o kēia kumu, akā, ʻoi aku ka maʻamau o kēia ma muli o ka hōʻiliʻili ʻana o ka ʻaʻai ma loko o ke kino.

ʻO ka paʻa ʻana i nā kahe ʻaʻole wale nō e hoʻopilikia i ka paona, akā ke kumu no hoʻi ka edema a me ka ulu kino ʻana o ka hana cardiac.
Me ka edema koʻikoʻi, hiki ke kōkua i ka hoʻohana ʻana o ka diuretics.

Hoʻokū pinepine ka puʻuwai naʻau i ka wā e hoʻohui pū ai nā thiazolidinediones me nā lāʻau lapaʻau e hoʻemi ana i ke kō, me ka insulin. Me monotherapy me thiazolidinediones a i ole insulin, ka liʻiliʻi o ka hōʻeha o ka puʻuwai puʻupuʻu - e liʻiliʻi loa i ka 1%, a i ka hui pū ʻana, piʻi ka nui i 3%.

Loaʻa paha ke kūkuluʻana i ka anemia ma 1-2% o nā hihia.

Ke ʻano o ka noi
Lawe ʻia ʻo Pioglitazone hoʻokahi manawa i ka lā. ʻAʻole i pili ka lāʻau lapaʻau i ka ʻai ʻana.

ʻO ka awelika nui he 15-30 mg, ʻo ka nui loa ka nui o 45 mg i kēlā me kēia lā.

Lawe ʻia ka Rosiglitazone i nā manawa 1-2 i ka lā. ʻAʻole pili ka lāʻau lapaʻau i ka ʻai ʻana.

ʻO ka dosage ka nui he 4 mg, ʻo ka nui loa ma ke ʻano he 8 mg i ka lā.

Nā hōʻailona no ka hoʻohana ʻana
Hoʻohana ʻia ia i nā mea maʻi me ka maʻi diabetes mellitus type 2, obese, a i nā mea maʻi me ka type 1 diabetes mellitus i hui pū ʻia me ka ʻomo ʻana o ka insulin.

I kēia manawa, hoʻohana lāʻau hoʻokahi o ka pūʻulu Biguanide - Metformin (Siofor, Avandamet, Bagomet, Glucofage, Metfogamma).

Kōkua ʻo Metformin e hōʻemi i ke kaumaha o ke kino ma ka awelika o 1-2 kg i kēlā me kēia makahiki.

Nā hana hana i ka hana
Hoʻololi ʻo Metformin i ka loaʻa ʻana o ka glucose i nā puʻuwai o ka naʻau, e alakaʻi ai i kahi kahe o ke kō koko.

Eia kekahi, kōkua ka metformin e hōʻemi i ka momona, a ma ka huli aʻe e alakaʻi i ka emi ʻana o ke kaumaha o ke kino.

Lapaʻau lāʻau
Ua hōʻea ʻo Metformin i kona kiʻekiʻe kiʻekiʻe ma hope o nā hola 1,5-2 ma hope o ka hoʻokele ʻana.

Mālama ʻia kona hōʻiliʻili ʻana i ke akea, nā ʻomaʻomaʻi a me nā kūlima salivary e ʻike ʻia.

Ke hoʻopio ʻia nei e nā ʻōpū. Ma ka hihia o kahi hana renal impaired, hiki ke hōʻiliʻili ka lāʻau.

Nā maʻi āpau: Hypersensitivity i ka lāʻau lapaʻau. ʻO ka hapai a me ka lactation. Hoʻopilikia i nā ate.

He mau makahiki ma mua o 60 mau makahiki.

Nā hopena hopena
Loaʻa paha kahi hoʻomohala i kahi anemia.

Hypoglycemia.
Kālai koho
E hoʻohana i ka lāʻau lapaʻau me ka mālama ʻana i nā maʻiʻeha o ka huehue, ke komo ʻana o ka hōʻemi ʻana, a me ka hōʻeha ʻana i nā maʻi maʻi.

Pono ʻoe e haʻalele i ka lāʻau lapaʻau lā 2-3 mau lā ma mua o ka hana a hoʻi hou i ka loaʻa ʻana o 2 mau lā ma hope o ka hana.

Malia paha he hui pūʻana o metformin me nā lāʻau lapaʻau e hoʻemi ana i ke kō, me ka insulin.

Nā hua palapala o nā sulfonylureas

Nā hōʻailona no ka hoʻohana ʻana
ʻAno 2 mellitus mika.

Nā hana hana i ka hana
ʻO ka mākaukau o ka hui derivatives sulfonylurea. Hana lākou i nā poli beta o ka pancreas a hoʻowalewale i ke ʻano o ka insulin.

Hoʻemi lākou i nā waiho glucose i loko o ka ate.

ʻO ka hopena ʻekolu e loaʻa ai kēia mau lāʻau ma ke kino ke ʻano lākou ma ka insulin iho, e hoʻonui ana i kona hopena ma nā ʻāpana kino.

Lapaʻau lāʻau
I kēia lā, ua hoʻohana ʻia nā derivatives sulfonylurea o ka wā 2.

Hoʻokā ʻia nā lāʻau palaka ma kēia pūʻulu ma o nā ʻōpū a me nā ate, me ka ʻike ʻole i ka glurenorm, kahi i hoʻopili ʻia e nā ʻōpū o loko.

Nā Kūmole - No ka maʻi mulini e pili ana i ka maʻiulinila.

ʻŌpū a me ka lactation.

Nā hopena hopena
Ma muli o ke kūpono o kēia mau lāʻau i ka huna ʻana i ka insulin, inā he overdose e hoʻonui lākou i ka makemake, kahi e hiki ai ke hoʻonui i ke kaumaha o ke kino. Pono e koho pololei i ka liʻiliʻi liʻiliʻi ma ka mea i hoʻokō ʻia ai kahi hopena hypoglycemic, i mea e pale aku ai i ka loaʻa ʻana o ka lāʻau lapaʻau.

ʻO kahi overdose o nā lāʻau lapaʻau ke hiki ke alakaʻi i ka kūʻē i ka lāʻau hōʻemi i ke kōpaʻa (ʻo ia hoʻi, ʻo ka hopena o nā lāʻau e hoʻohiolo ana i ke kō.

Hiki i nā lāʻau lapaʻau ma kēia pūʻulu ke kumu i ka hypoglycemia. ʻAʻole hiki iā ʻoe ke hoʻonui i ka nui o nā lāʻau lapaʻau me ke ʻole e kūkā ʻana i kahi kauka.

Hiki ke loaʻa nā ʻōmole Gastrointestinal i ke ʻano o ka nausea, ʻano nui ka hoʻohālikelike, ka maʻi ʻōpū, a i ʻole ka constipation.

Allergic reaksi ma ke ʻano o ka urticaria a me ka gikalike i kekahi manawa.

Loaʻa paha ka hoʻomohala ʻana o ka anemia o ke ʻano hōʻole.

Ke ʻano o ka noi
ʻO ka hapa nui o ka hoʻomākaukau ʻana o ka pūʻulu "Derivatives o sulfanylureas" he hopena hypoglycemic no 12 mau hola, no laila e lawe pinepine ʻia lākou i ʻelua mau lā i kēlā lā.

Hiki ke lawe i ʻekolu mau lā i ka lā e mālama ana i ka ʻokoʻa o ka lā. Hana ʻia kēia no ka hopena maikaʻi o ka lāʻau.

Kālai koho
He hopena lōʻihi ka lōʻihi o ka Gliclazide a me ka glimepiride, no laila lawe ʻia lākou i hoʻokahi lā.

Meglitinides (Nesulfanylurea Secretagogues)

ʻO kēia nā regulators glucose prandial, hoʻokomo lākou i ka hoʻonuiʻana i ka huna ʻana i ka insulin, e hoʻopilikia ana i nā puna beta o ka pancreas.

Hoʻohana ʻia ʻelua mau lāʻau o kēia pūʻulu - ʻo Repaglinide (Novonorm) a me Nateglinide (Starlix).

Nā hōʻailona no ka hoʻohana ʻana
Non-insulin-hilinaʻi mellitus mellitus me ka ikehu ole e ole ai.

Hoʻokomo i ka hana Kaʻi i ka hana o ka insulin.ʻO kā lākou hana e hoʻōki nei i ka hoʻemi ʻana i ka hyperglycemia prandial, ʻo ia hoʻi, ʻo ka hyperglycemia ma hope o ka ʻai ʻana, ʻaʻole lākou i kūpono no ka hoʻēmi ʻana i ka paʻakai ʻai.

Hoʻomaka ka hopena hypoglycemic i nā lāʻau lapaʻau ma 7-15 mau minuke ma hope o ka lawe ʻana i ka paila.

ʻAʻole lōʻihi ka hopena o ka hypoglycemic o kēia mau lāʻau, no laila he mea pono ia e lawe iā lākou i kekahi mau manawa i ka lā.

Hoʻopau nui ʻia e ka ate.
Nā Contraindications Insulin-dependence diabetes mellitus. ʻO ka ʻōpū a me ka lactation. Makahiki ma lalo o 18 mau makahiki.

Hiki ke loaʻa nā ʻōmole Gastrointestinal i ke ʻano o ka nausea, ʻano nui ka hoʻohālikelike, ka maʻi ʻōpū, a i ʻole ka constipation.

Allergic reaksi ma ke ʻano o ka urticaria a me ka gikalike i kekahi manawa.

Kekahi luhi, hiki i nā lāʻau ke hōʻola i kēia pūʻulu ke kumu i ka hypoglycemia.

Malia paha e hoʻonui i ke koʻikoʻi o ke kino ke lawe nei i nā lāʻau lapaʻau.

Malia paha i ka hoʻomohala ʻana o ka hoʻohui i Meglitinides.

Ke ʻano o ka noi
Lawe ʻia ka repaglinide i ka hapalua hola ma mua o ka papaʻai 3 mau manawa i kahi lā (ma mua o kēlā me kēia ʻai).
ʻO ka nui pākahi huakaʻi he 4 mg, kēlā me kēia lā - 16 mg.

Lawe ʻia ʻo Nateglinid B.yzftu ma mua o ka papaʻai no nā minuke 10 i 3 mau manawa i ka lā.

Kālai koho
Malia paha e hui pū me nāʻaila e hoʻohaʻahaʻa i nā hui ʻē aʻe, no ka laʻana, me ka metformin.

Hoʻopuka nā Acarbose (α Glycosidase Inhibitors)

Nā hōʻailona no ka hoʻohana ʻana: Mellitus-non-insulin-mellitus.

E like me ka prophylaxis o nā ʻano maʻi mellitus type 2 i loko o ka poʻe me ka hoʻomanawanui i ka hoʻoliʻi glucose.

Nā hana hana i ka hana
Hoʻemi lākou i ka laweʻana o ka glucose i ka palupalu ma muli o ka mea i hoʻopaʻaʻia lākou i nā enzyme e wāwahi i ka protein a pale i kēia mau enzyme e holoi. Hoʻopili ʻia nā mea huna i ka ʻōpū o nā iwi i ka huina.

ʻAʻole pili ia i ke kiʻekiʻe o ka insulin synthesized, no laila, ʻaʻole i haʻalele ka hopena o ka uluʻana o ka hypoglycemia.

Kōkua ia i ka hoʻemi ʻana i ke kaupaona o ke kino ma muli o ka lilo ʻana o ia i ka hoʻopale ʻana o nā ʻaloli ma ka ʻawa.
Lapaʻau lāʻau
ʻElua mau pānaehana hana - ma hope o 1,5 - 2 mau hola ma hope o ka lawe ʻana i ka lāʻau lapaʻau a ma hope o 16-20 hola.

ʻAe ʻia ia e ka gastrointestinal tract. Hoʻokuʻu ʻia ia ma o nā ʻāpana lau, ma lalo o nā keiki.
Nā Hoʻohui
ʻO nā maʻi o ka huehue a me nā maʻi koʻikoʻi o ka papa gastrointestinal i ka wā o ka exacerbations.

ʻO nā maʻi o ka ate, me ka cirrhosis.

ʻŌpū a me ka lactation.

Pōpiopio a me 18 makahiki - e akahele me ka akahele.

Nā hopena hopena
Mai ka ʻeha gastrointestinal - nausea, luaʻi, ka hū.

Ke hoʻopau nei i nā palaka, e hoʻomohala paha ka lemulewa a lawe ʻia ka lāʻau lapaʻau.

Allergic reaksi - urticaria, itching.

Hiki ke hiʻohiʻona o ka edema.

Pehea e hoʻohana ai: Lawe i kahi hola ma mua o ka papa ʻaina ʻekolu mau manawa i ka lā.

E hoʻomaka me ka palena haʻahaʻa liʻiliʻi a hoʻonui i ka nui o ka nui.

Kālai koho
Hoʻopuka i kahi mea hanu, nā hōʻeha, nā maʻi ʻeha e hōʻea i kahi wā hoʻomaha o ka lāʻau a me ka neʻe ʻana i ka maʻi insulin.

Pono e hahai ikaika i ka papaʻai me kahi haʻahaʻa haʻahaʻa o nā hāmeʻa "wikiwiki".

Loaʻa ka hopena o ka lāʻau i ka hopena-hilinaʻi nui o ka dosis - ke kiʻekiʻe o ka nui, ke emi nei ka nui o nā hāmeʻe.

Malia paha e hui pū me nā lāʻau lapaʻau e hoʻohaʻahaʻa i ka wai. Pono e hoʻomanaʻo ʻia ka hoʻonui ʻana o ka acarbose i ka hopena o nā lāʻau lapaʻau haʻahaʻa.