I kekahi manawa ʻaʻole hiki i nā meaʻai kūikawā a me ka hana kino ke hāʻawi i kahi kiʻekiʻe glucose maʻamau i kahi maʻi maʻi me kahi 2 o kahi maʻi.

Kahi waiwai me ka INN Repaglinide, ka ʻōlelo aʻo i hoʻopili ʻia i kēlā me kēia pākī o ka lāʻau i loaʻa iā ia, he hopena hypoglycemic i ka wā i hiki ʻole ai ke kāohi i ka ʻaila o ke kō i loko o ke koko. E hoʻopuka kēia ʻatikala i ka nīnau pehea e hoʻohana ai i ka lāʻau lapaʻau me ka repaglinide pololei a i kahi hiki ke hoʻohana ʻia.

Pharmacological waiwai o ka lāʻau

Loaʻa ka papa hana kūpono, ʻo Repaglinide, i ka puka pauka keʻokeʻo no ka hoʻohana kūloko. ʻO ka hoʻokō o ka hana o ka hana ke hoʻokuʻu i ka insulin (kahi hormone hoʻohaʻahaʻa i ke kōpaʻa) mai nā lāʻau beta i loaʻa i ka pancreas.

Ke hoʻohana nei i ka repaglinide ma luna o nā mea hopu kūikawā, i hoʻopaʻa ʻia nā hāmeʻa hilinaʻi ATP i loko o nā membranes o nā sel beta. Ke hoʻonāukiuki kēia kaʻina hana i ka depolarization o nā pūpū a me ka wehe o nā kanalula kalepa. I ka hopena, hoʻonui ʻia ka hana o ka insulin ma ka hoʻonui ʻana i ka hoʻoili ʻana o ka calcium.

Ma hope o ka lawe ʻana i ka maʻi i kahi o Repaglinide, ua hoʻihoʻi ʻia ka waiwai i loko o ka huina. I ka manawa like, ma hope o 1 mau hola ma hope o kaʻai ʻana, ua ʻoi loa ia i loko o ke koko koko, a laila ma hope o 4 hola mau manawa e hoʻemi nui ana kona waiwai a lilo i haʻahaʻa loa. Ua hōʻike ʻia nā haʻawina o ka lāʻau lapaʻau ʻaʻohe ʻano nui o nā waiwai i ka wā pharmacokinetic i ka wā hoʻohana ʻia ʻo Repaglinide ma mua a i ʻole i loaʻa i ka pāʻina.

Hoʻopili ka mea i nā protein plasma ma mua o 90%. Eia nō hoʻi, hiki i ka bioavailability pololei loa i ka 63%, a ʻo kona neʻe ʻana he 30 lita. ʻO ia i loko o ka palupalu e kū mai ana ka biotransformation o Repaglinide, ma muli o ka mea hana i nā metabolite i hana ʻole ʻia. Kūkulu, ua excreted lākou me ka bile, a me ka urine (8%) a me nā feces (1%).

30 mau minuke ma hope o ka hoʻopau ʻana iā Repaglinide, hoʻomaka ka hona ʻana. ʻO ka hopena, hōʻemi nui ka ʻaila o ka glucose i ke koko. Ma waena o nā meaʻai, ʻaʻohe mea e piʻi i ka pae o ka insulin.

I ka poʻe maʻi me ka maʻi maʻi ole-insulin e lawe ana mai ka 0.5 a me 4 g ʻo Repaglinide, ua mālama ʻia kahi emi ʻana o ka maʻi i ka glucose.

Nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau

ʻO Repaglinide ka mea nui i NovoNorm, ka mea i hoʻoili ʻia ma Tenemaka. Hoʻopuka i kahi lāʻau lapaʻau nā Novo Nordisk A / C i ka lāʻau lapaʻau ma ke ʻano o nā papa me nā ʻaina like ʻole - 0,5, 1 a me 2 mg. Hoʻokahi i hoʻokahi blister he 15 mau papa, i loko o hoʻokahi pākē he nui nā blisters paha.

I kēlā me kēia pūʻulu o ka lāʻau lapaʻau me ka māhele repaglinide, kauoha ʻia no ka hoʻohana ʻana. Koho ʻia nā Dosages e ka mea lapaʻau ponoʻī o kekahi e mālama i ka pae o ke kō a me nā ala e pili ana i ka mea maʻi. Ma mua o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono e heluhelu pono ka mea maʻi i nā ʻōlelo pili i hoʻopili ʻia.

ʻO 0.5 mg ka palena mua, hiki ke hoʻonui ʻia ma hope o hoʻokahi a ʻelua pule paha, e hoʻoneʻe ana i nā hoʻokolohua laboratory no nā pae gula. ʻO ka nui loa ka nui o ka dosage he 4 mg, a ʻo kēlā me kēia lā he 16 mg. I ka wā o ka hoʻololi mai kahi lāʻau lapaʻau hou-hoʻohiolo ʻo Repaglinide e lawe i ka 1 mg. Hoʻouna ʻia e hoʻohana i ka lāʻau lapaʻau 15-30 mau minuke ma mua o ka papa kai nui.

Pono mālama ʻia nā lāʻau lapaʻau NovoNorm mai nā keiki liʻiliʻi ma kahi mahana o ke ea 15-25C ma kahi e pale ʻia ai ka lepo.

ʻO ke ola o ka lāʻau noho i ka lā a hiki i ka 5 mau makahiki, ma hope o kēia manawa hiki ʻole ke hoʻohana iā ia i kēlā me kēia hihia.

ʻO nā maʻi a me nā hōʻeha

ʻO ka mea pōʻino, ʻaʻole hiki i nā mea āpau ke talia i ka NovoNorm. E like me nā lāʻau lapaʻau, he contraindications ia.

ʻAʻole hiki ke lawe ʻia ka pūhui repaglinide me:

insulin-dependant type o ka maʻi maʻi
diabetes ketoacidosis, komo i coma,
iha ikaika a / a i ʻole a male ʻole o ka palaka,
hoʻohana hou aku i nā lāʻau lapaʻau e koi ai a hōʻeha paha i ka CYP3A4,
lolika lactose, hemahema o ka lactase a me ka malabsorption glucose-galactose,
hoʻonui mahuahua i ka waeia,
malalo o 18 makahiki
Hoʻolālā a hoʻomau i ka wā hāpai,
hana waiū.

Ua hōʻike ʻia nā loiloi e hana ʻia i nā kiʻi i ka hoʻohana ʻana i ka repaglinide i ka manawa o ka hānai ʻana i ke keiki i hoʻopōʻino ʻia i ka pūpū. Ma muli o kahi hoʻohālikelike, ua hoʻopilikia ka hoʻolālāʻana o nā ʻoi loa a me nā haʻahaʻa haʻahaʻa. Pēlā nō, pāpā ʻia ka hoʻohana ʻana o ke ʻano i ka wā lactation, me ka lawe ʻia me ka waiū makuahine i ka pēpē.

I kekahi manawa me ka hoʻohana pono ʻole ʻana i ka lāʻau lapaʻau a i ʻole ka overdose, ke ʻano o nā hopena maikaʻiʻole e like me:

hypoglycemia (hoʻonui nui loa, nā mea hōʻeha, ka hiamoe maikaʻi ʻole, tachycardia, hopohopo),
nā hana ino o ka mea ʻike ʻike mua (ma ka mua, lawe i ka lāʻau lapaʻau, a laila hala)
hoʻoweliweli ka huhū (ʻeha o ka ʻōpū, ʻōpū a me ka luaʻi, constipation a maʻi paha, hoʻonui i ka hana o nā enzymes i loko o ka puʻuwai),
allergy (redness o ka ʻili - erythema, rash, itching).

ʻO ka hoʻohana nui ʻana o ka nui o ka lāʻau lapaʻau ma mua o ke kauka ʻana i hōʻike pinepine ai e hoʻoulu pinepine ana i ka hypoglycemia. Inā kuhi ka maʻi maʻi maʻi i ka pili ʻana i ka maʻi overdose a ʻike iā ia, pono ia e ʻai i nā huahana momona, a e kamaʻilio i kahi kauka e pili ana i ka hoʻoponopono dosis.

Ma ka hypoglycemia koʻikoʻi, ke hele nei ka mea maʻi i kahi pōʻino a i ʻole ka naʻaupō, ʻike ʻia ʻo ia me ka hopena o ka glucose 50% ma lalo o ka ʻili me ka hoʻoulu hou ʻana o ka hopena 10% e mālama i ke kōla kōpaʻa ma ka liʻiliʻi o 5.5 mmol / L.

Nā hopena o nā Repaglinide me nā lāʻau lapaʻau ʻē aʻe

Hoʻohana pinepine ka hoʻohana ʻana i nā lāʻau kūmau concomitant i ka hopena o ka repaglinide ma ka nānā ʻana i ka glucose.

Hoʻonui ʻia kona hopena hypoglycemic i ka wā e lawe ai ka mea maʻi i ka MAO a me ACE inhibitors, non-selective beta-blockers, non-steroidal anti-inflammatory drugs, salicylates, anabolic steroid, okreotide, lāʻau lapaʻau e loaʻa ana ka ethanol.

ʻO nā lāʻau lapaʻau e hiki ke hoʻopilikia i ka hiki ke hiki i kahi mea e hōʻemi i ka glucose.

nauwe
ʻāpoʻa no ka hoʻohana ʻana i ka waha,
danazol
kekahula
ʻO nā hormones thyroid
haluluHalakalaha.

Eia kekahi, pono e ʻike ka mea maʻi e launa pū ka repaglinide i ka lāʻau me ka mea i hoʻopili ʻia i ka nui ma loko. Nā CYP3A4 inhibitors e like me ka intraconazole, ketoconazole, fluconazole a me nā mea'ē aʻe hiki ke hoʻonui i ke koko. ʻO ka hoʻohana ʻana o CucP3A4 inducers, ma ka rifampicin a me ka phenytoin, e hoʻohaʻahaʻa i ka pae o kahi mea i loko o ka plasma. Hāʻawi ʻia i ka ʻike ʻole o ka pae o ka hoʻonāukiuki ʻana, ʻaʻole ia i hoʻohana ʻia nā hoʻohana ʻana o Repaglinide me nā lāʻau like ʻole.

Hoʻokomo ʻo

Hoʻokomo ʻo


ʻO ka hoʻohui ʻili
IUPAC	(S) - (+) - 2-ethoxy-4-2- (3-methyl-1-2- (piperidin-1-yl) phenylbutylamino) -2-oxoethylbenzoic acid
Hōʻailona kalepona	C₂₇H₃₆N₂O₄
Papale ʻaʻa	452.586 g / mol
Kēlā	135062-02-1
PubChem	65981
Kāleka	DB00912
Kahi helu
ATX	A10BX02
Lapaʻau lāʻau
Bioavailable	56% (waha)
Palapala ʻaila Plasma	>98%
Hāpai	Hepatic oxidation a me glucuronidation (CYP3A4-mediated)
Ka hapalua ola.	1 hola
ʻĀina	Fecal (90%) a me ka renal (8%)
Kahi alanui hoʻokele
Oralaka
Nā Faila Media Commons

Hoʻokomo ʻo - lāʻau lapaʻau antidiabetic, ua hana ʻia ma 1983. ʻO ka repaglinide kahi lāʻau lapaʻau waha i hoʻohana ʻia i ka ʻai a me ka hana e kaohi ai i ke kō koko koko i ke ʻano maʻi type 2. Hoʻomoe ka hana o ka hana ʻo Repaglinide i ka hoʻonui ʻana i ka hoʻokuʻu i ka insulin mai nā cells-islet cells o ka pancreas, e like me nā lāʻau hou antidiabetic, ʻo ka hopena hopena ka hypoglycemia. Ke kūʻai aku nei ka lāʻau lapaʻau e Novo Nordisk ma lalo o ka inoa Prandin i USA Hoʻolauleʻa ma Kanada Kahuanui ma lapana Hoʻokomo ʻo i Aikupito e Ifi, a NovoNorm ma kahi e. Ma Iapana, ua hana ʻia e Dainippon Sumitomo Pharma.

Pūnaewele naʻauao

ʻO ka repaglinide kahi lāʻau lapaʻau waha i hoʻohana ʻia i ka ʻai a me ka hana e kaohi ai i ke kō koko koko i ke ʻano maʻi type 2.

Nā Hoʻohui

Repaglinide is contraindicated in the people with:

Maʻi molaʻi
ʻAno maʻi type 1
Hoʻohana pono me ka gemfibrozil
ʻO ka hypersensitivity i ka lāʻau lapaʻau a i ʻole nā mea i hōʻemi ʻia

Nā hopena hopena

Loaʻa nā hopena maʻamau:

Nā maʻi respiratory tract (16%)
Sinusitis (6%)
Rhinitis (3%)

Hoʻokomo ʻia nā hopena koʻikoʻi:

Ischemia isociaʻe (2%)
ʻAno ʻO Angina Pectoris (1.8%)
ʻO ka make ma muli o nā hanana cardiovascular (0.5%)

No nā poʻe kūikawā

ʻ Categorylelo Wāwae C: Ua mālama ʻia i ka palekana no nā wahine hāpai. Ua kaupalena ʻia nā ʻikepili, a hoʻokahi wale nō hihia, ʻike ʻia ka hōʻike ʻana ʻaʻohe loina me ka hoʻohana ʻana o ka repaglinide i ka wā hāpai ʻia.

Pono e mālama pono i ka mālama ʻana me ka poʻe me ka maʻi ʻōpiopio a hoʻemi i ka hana o ka keiki i ka wā e hoʻohana ai i kēia lāʻau.

Hoʻohui nūhou

ʻO Repaglinide ka papa kuhikuhi o ka SUR3A4 a ʻaʻole pono e kuhikuhi i ka manawa like me ka gemfibrozil, clarithromycin, a i nā mea āpau azif antifungal e like me Itraconazole a me Ketoconazole. ʻO ka lawe pū ʻana i ka repaglinide me hoʻokahi a i ʻole paha o kēia mau lāʻau ke alakaʻi i ka hoʻonui ʻana i nā kukuna hoʻi wai repaglinide a hiki ke alakaʻi i ka hypoglycemia. Co-hoʻokele ʻo clopidogrel a me ka repaglinide (a me kahi cyp2c8 inhibitor) hiki ke alakaʻi i kahi nui o ke kaila o ke koko ma muli o nā hopena o ka lāʻau. ʻo kaʻoiaʻiʻo, ʻo ka hoʻohana ʻana i kēia mau lāʻau lapaʻau hoʻokahi no ka liʻiliʻi loa i hoʻokahi lā hiki ke alakaʻi i ka hypoglycemia koʻikoʻi. ʻAʻole pono ke lawe ʻia ʻo Repaglinide i ka hui me ka sulfonylurea, no ka mea ke ʻano o ka hana o lākou.

Nā hana hana i ka hana

ʻO ka repaglinide hoʻohaʻahaʻa i ka hoʻokahe koko me ka hoʻowalewale ʻana i ka hoʻokuʻu ʻia o ka insulin mai nā hua beta o ka mokupuni pancreatic. Loaʻa kēia i ka pani ʻana i nā hāmeʻa pākela me ka nauka o ka papa ATP me ka huapau o nā pū beta. Hoʻomoe kēia i nā wahī o ka beta, wehe i nā kanaleka cellular, a ma muli o ka hopena, ke kaohi mai o ka calcium e hoʻonāukiuki i ka huna ʻana i ka insulin.

Lapaʻau lāʻau

Loaʻa: He 56% bioavailability o 56 Repaglinide i ka wā i lawe ʻia ai mai ka gastrointestinal tract. Hoʻemi ʻia ka bioavailability i ka wā e lawe ʻia ai me ka meaʻai, hoʻemi ʻia ka nui o ke koʻo e ka 20%.

ʻO ka hoʻohālikelike: ʻo ka hōʻaiʻe o ka protein no ka repalglinide i ka albumin ma mua o 98%.

Metabolism: Ka hoʻohālikelike ʻana o Repaglinide i loko o ka puʻuwai, inā hoʻi i ka CYP450 2C8 a me 3A4 a i ka liʻiliʻi me ka glucuronidation. Hoʻokomo ʻole nā metabolits Repaglinide a ʻaʻole i ka hōʻike i nā hopena haʻahaʻa i ke kō.

Hoʻohālikelike: ʻO Repaglinide kahi 90% i hoʻopuka ʻia i loko o nā feces a me 8% i ka urine. Hoʻokuʻu ʻia ka 0.1% me ka urine i loli ʻole. Kēlā i ka 2% i hoʻololi ʻia i nā moena.

ʻO ka moʻolelo

Ua hana ʻia ʻo mua no ka Repaglinide i nā makahiki 1983 ma Bieberrach ma Rice ma ka hema o Kelemānia.

Pūnaewele naʻauao

Ma ʻAmelika Hui Pū ʻIa, pale ʻia e Patent, ua hoʻopaʻa ʻia ke kau inoa ma Malaki 1990, a ka mea i lilo i lilo i US kiaʻi 5,216,167 (Iune 1993), 5,312,924 (Mei 1994) a me 6,143,769 (Nowemapa 2000). Mahope iho

Nā manaʻo e hoʻohana

I kekahi mau kūlana, pono i nā mea maʻi ke hoʻohana i ka lāʻau lapaʻau me ka mālama nui loa ma lalo o ka nānā ʻana o kahi kauka i kuhikuhi i ka palena liʻiliʻi o ka lāʻau. Hoʻokomo ka mea maʻi i nā mea maʻi e loaʻa mai ana i nā ala o ke ake a me / a i ʻole paha i kaʻi, ka mea i loaʻa i ka nui o ka hōʻemi o ka hōʻiliʻili nui, ka mea hou nei i loaʻa i ka maʻi a maʻi aʻai paha, nā poʻe ʻelemakule (mai 60 mau makahiki he nui) ka mea e pili ana i kaʻai haʻahaʻa.

Inā loaʻa ka mea maʻi i ka kūlana hypoglycemic ma ke ʻano maʻalahi a maʻalahi paha, hiki ke hoʻopau ʻia kūʻokoʻa. No ka hana i kēia, pono ʻoe eʻai i nā meaʻai i nā mea momona maʻalahi - nā ʻāpana o ke kō, ke kō, nā wai ʻala, nā hua momona paha. Ma ka palapala koʻikoʻi me ka nalowale o ka hoʻomaopopo ʻana, e like me ka mea i ʻōlelo ai ma mua, he lawelawe glucose ʻana e mālama ʻia ma loko o ka intravenously.

Pono e hoʻomaopopoʻia ua hiki i nā beta-blockers ke uhi i nā hōʻailona o ka hypoglycemia e puka mai nei. Hōʻike ikaika nā kauka i ka pale ʻana i ka inu ʻawa ma ka hoʻonui ʻana i ka etanol a hoʻomau i ka hopena hypoglycemic o Repaglinide.

Eia kekahi, hoʻemi ka mea o ke nānā i ka nānāʻana.

No laila, ʻo nā mea hoʻokele e kū'ē i ke ʻano o ka hoʻohana ʻana i ka repaglinide, pono ia e pale i ke kaʻa ʻole ʻana a i ʻole hana i nā hana ʻē aʻe i ka wā o ka ʻoihana.

ʻO ke kumukūʻai, nā loiloi a me nā hoʻohālike

Hoʻohana ʻia ʻo Repaglinide e like me ka mea nui i ka lāʻau lapaʻau NovoNorm.

Hiki ke kūʻai ʻia ia ma ka hale kūʻai a ʻokoʻa paha ma ka pūnaewele ma ka pūnaewele kūʻai a ka mea kūʻai aku. Eia nō naʻe, hiki ke kūʻai ʻia i ka lāʻau ke hiki i ka hōʻike ʻana o ke kauka lāʻau.

He ʻano ke kumukūʻai o ka lāʻau lapaʻau:

1 mg mau papa (30 mau ʻāpana i kēlā me kēia pēpē) - mai 148 a 167 mau lālani Lūkini,
2 mg papa (30 mau ʻāpana no ka pā) - mai ka 184 a 254 mau rubles Lūkini.

E like me kāu e ʻike ai, kūpono ke kumukūʻai no ka poʻe me ka uku haʻahaʻa. ʻO ka heluhelu ʻana i nā loiloi o nā maʻi maʻi maha, hiki ke hoʻomaopopo ʻia he mea nui ka uku haʻahaʻa o ka lāʻau lapaʻau, i hāʻawi ʻia i kona pono. Eia kekahi, ʻo nā pono pono o NovoNorm:

maʻalahi o ka hoʻohana ʻana i nā papa i hoʻohālikelike ʻia i injections,
ka wikiwiki o ka lāʻau, i ka hola 1 wale nō.
lōʻihi ka lawe ʻana i ka lāʻau lapaʻau.

ʻO ka mea hope loa ka hapanui o nā poʻe maʻi e loaʻa ana i ka diabetes-depend-non-diabetes i lawe i ka NovoNorm no 5 mau makahiki a ʻoi paha. Kuhi lākou ʻaʻole e waiho nā hana a ʻaʻole i lapuwale. Eia nō naʻe, ua hoʻemi ʻia ka hopena hypoglycemic o ka lāʻau lapaʻau i ke kī ʻole inā NOT:

pili i nā meaʻai kūpono (ka wehe ʻana o nā momona kālai ʻia a me nā momona),
nānā i kahi hana ola (hele no nā 30 mau minuke, hoʻomaʻamaʻa pilikino, etc.),
mālama mau i ke pae o ka glucose (ma ʻekolu mau manawa a i ka lā).

Ma keʻano ākea, nā maʻi a me nā kauka e manaʻo nei ʻo NovoNorm he antipyretic maikaʻi loa. Akā i kekahi manawa ua pāpā ʻia ka hoʻohana ʻana i nā papa, ʻoiai lākou e alakaʻi i nā hopena kūpono ʻole. I kēlā mau kūlana, ke hoʻoholo nei ke kauka e hoʻololi i ka ʻano o ka lāʻau lapaʻau a i ʻole ke kuhikuhi i kahi lāʻau lapaʻau ʻokoʻa loa.

Hoʻokomo pū ʻia nā hua ʻōlelo like ʻole a me nā ʻokoʻa ʻē aʻe. ʻO nā papa NovoNorm hoʻokahi wale nō kahaluna - Diagniniside (kahi awelika o 278 mau rubles).

Nā huina likeʻo NovoNorm, kahi ʻokoʻa i ko lākou māhele, akā like ka hopena.

Jardins (kumukūʻai kumukūʻai - 930 rubles),
ʻO Victoza (kumukūʻai kumukūʻai - 930 rubles),
Saksenda (kumukūʻai kumukūʻai - 930 rubles),
Forsyga (kumukūʻai kumukūʻai - 2600 rubles),
Invokana (kumukūʻai kumukūʻai - 1630 rubles).

Hiki iā ia ke hoʻoholo i ka lāʻau lapaʻau NovoNorm, ka mea i loaʻa i ka repaglinide mau mea ikaika, e kūlea ana i ka mālama ʻana o ka maʻi maʻamau ʻo 2. Hoʻololi koke ia i nā pae kō i ke kō. Inā ʻoe e hāhai i kahi o ka meaʻai, ka hana kino a me ka mālama mau ʻana i ka hoʻoliʻiliʻi o ka glucose, hiki iā ʻoe ke kāpae i ka hypoglycemia a me nā hōʻailona koʻikoʻi o ka maʻi maʻi. ʻO ke wikiō i kēia ʻatikala e haʻi iā ʻoe pehea e mālama ai i ka maʻi maʻi.