Cov tshuaj noj ntawm cov ntsiav tshuaj Diagnlinid

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb Cov Duab Tsim Tshuaj LiabCov. Muab tswv yim los ntawm cov neeg tuaj saib rau ntawm thaj chaw - cov neeg siv khoom ntawm cov tshuaj no, nrog rau kev xav ntawm cov kws kho mob tshwj xeeb txog kev siv tshuaj Repaglinide hauv lawv qhov kev coj ua. Qhov kev thov loj yog nquag ntxiv kev tshuaj xyuas koj ntawm cov tshuaj: cov tshuaj tau pab lossis tsis pab ua kom tshem tawm ntawm tus kabmob, muaj dab tsi tshwm sim thiab cov kev mob tshwm sim, tejzaum nws tsis tshaj tawm los ntawm tus tsim khoom hauv cov lus piav qhia. Cov cim ntawm Repaglinide nyob rau hauv muaj cov qauv txheej txheem qauv. Siv rau kev kho mob ntawm qhov tsis-insulin-hom mob ntshav qab zib 2 hauv cov neeg laus, menyuam yaus, nrog rau lub sijhawm cev xeeb tub thiab lactation. Cov tshuaj muaj pes tsawg leeg thiab cuam tshuam nrog cawv.

Cov Duab Tsim Tshuaj Liab - tus kab mob no qhov ncauj hypoglycemic. Sai sai txo cov ntshav piam thaj los ntawm kev txhawb nqa tawm tso tawm ntawm insulin los ntawm kev ua haujlwm ntawm pancreatic beta hlwb. Qhov kev ua haujlwm ntawm kev txiav txim siab yog cuam tshuam nrog kev muaj peev xwm los thaiv adenosine triphosphate (ATP) cov tub ntxhais nyob rau hauv cov kab mob beta-cell los ntawm kev ua ntawm cov receptors tshwj xeeb, uas ua rau lub depolarization ntawm cov hlwb thiab qhib cov calcium calcium. Raws li qhov tshwm sim, cov calcium calcium ua kom zoo tsim cov insulin secretion los ntawm beta hlwb.

Tom qab noj cov tshuaj Repaglinide, qhov tshuaj insulinotropic rau kev noj zaub mov raug pom zoo hauv 30 feeb, uas ua rau txo qis cov ntshav qabzib. Hauv nruab nrab ntawm cov pluas noj, tsis muaj qhov nce hauv insulin. Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus (non-insulin-dependant) thaum noj cov tshuaj Repaglinide ntawm 500 μg rau 4 mg, qhov kev cia siab-txo qis hauv cov ntshav qabzib tau raug sau tseg.

Muaj pes tsawg leeg

Tus neeg mob + cov pab neeg.

Cov Tshuaj Pharmacokinetics

Tom qab kev tswj hwm ntawm qhov ncauj, repaglinide nrawm nrawm los ntawm lub plab zom mov (GIT), thaum nws qhov siab tshaj plaws nyob rau hauv cov ntshav tau mus txog 1 teev tom qab noj, tom qab ntawd cov qib ntawm cov tshuaj repaglinide nyob rau hauv cov ntshav tau sai sai thiab tom qab 4 teev nws ua qis heev. Tsis muaj qhov sib txawv hauv qhov chaw kho mob hauv qhov chaw muag tshuaj ntawm repaglinide thaum noj tam sim ntawd ua ntej noj mov, 15 thiab 30 feeb ua ntej noj mov lossis hauv plab khoob. Plasma protein khi yog ntau dua 90%. Repaglinide yog yuav luag tag nrho cov khoom biotransformed hauv daim siab nrog rau kev tsim cov roj ntsha tsis ua haujlwm. Cov tshuaj Repaglinide thiab nws cov metabolites yog cov tawm nrog cov kua tsib, tsawg dua 8% nrog cov zis (raws li metabolites), tsawg dua li 1% nrog mob quav (tsis hloov).

Cov Khoom Qhia

• non-insulin-diabetes ntshav mellitus (hom 2 mob ntshav qab zib mellitus).

Tso Tawm Cov Ntawv

Cov ntsiav tshuaj 0.5 mg, 1 mg thiab 2 mg.

Cov lus qhia rau kev siv thiab ntau npaum li cas

Kev muab tshuaj yog muab teeb tsa ib qho zuj zus, xaiv ib koob tshuaj txhawm rau txhawm rau ua kom cov qib qabzib zoo.

Qhov pom zoo kom pib lub koob tshuaj yog 500 mcg. Ua kom cov koob tshuaj ntau dua yuav tsum tau nqa tawm tsis dhau lub sijhawm tom qab 1-2 lub limtiam ntawm qhov kev nqus, nyob ntawm kev ntsuas ntawm cov metabolism hauv cov khoom noj kom rog.

Cov koob tshuaj ntau: ib leeg - 4 mg, txhua hnub - 16 mg.

Tom qab siv lwm cov tshuaj hypoglycemic, qhov xav kom pib siv yog 1 mg.

Txais ua ntej txhua pluas mov tseem ceeb. Qhov zoo tshaj plaws lub sijhawm ntawm kev noj tshuaj yog 15 feeb ua ntej noj mov, tab sis tuaj yeem noj 30 feeb ua ntej noj mov lossis tam sim ntawd ua ntej noj mov.

Sab sij huam

• cuam ​​tshuam rau cov metabolism hauv carbohydrate - hypoglycemic tej yam kev mob (pallor, nce tawm hws, palpitations, pw tsaug zog tsis meej, tshee),
• kev hloov pauv hauv cov ntshav hauv cov ntshav tuaj yeem ua rau pom kev tsis txaus siab ib ntus, tshwj xeeb thaum pib kho (sau tseg rau qee tus neeg mob tsawg thiab tsis tas yuav txiav cov tshuaj ntxiv),
• mob plab
• raws plab, cem quav,
• xeev siab, ntuav,
• nce kev ua si ntawm daim siab enzymes,
• kev ua xua: ua pob khaus, erythema, urticaria.

Cov Yuav Tsum Muaj

• yam 1 mob ntshav qab zib mellitus (insulin-dependant),
• ketoacidosis uas mob ntshav qab zib (nrog rau mob tsis xeev)
• mob raum tsis zoo,
• mob siab ua rau daim siab,
• kho kev sib txuas nrog cov tshuaj uas tiv thaiv lossis ntxias CYP3A4,
• cev xeeb tub (suav nrog kev npaj ua) thiab lactation (pub niam mis),
• lub siab ncaj rau qhov chaw tawm.

Cev xeeb tub thiab lactation

Kev siv cov tshuaj Repaglinide thaum cev xeeb tub thiab lactation yog contraindicated.

Hauv kev sim tshuaj, nws tau pom tias tsis muaj teebmeem teratogenic, tab sis thaum siv cov koob tshuaj ntau hauv cov nas nyob rau theem kawg ntawm cev xeeb tub, embryotoxicity thiab kev txhim kho ntawm cov ceg tawv hauv cov menyuam hauv plab tau pom.

Cov tshuaj Repaglinide ua rau cov kua mis tawm tsis tau.

Siv rau menyuam yaus

Daim ntawv thov thaum tseem yau tsis tau piav.

Cov lus qhia tshwj xeeb

Hauv cov kab mob ntawm daim siab lossis lub raum, kev phais mob ntau, tom qab muaj mob lossis kab mob tsis ntev los no, qhov txo qis ntawm qhov ua tau ntawm Repaglinide yog ua tau.

Siv nrog ceev faj hauv cov neeg mob raum.

Hauv cov neeg mob debilitated lossis hauv cov neeg mob uas tsis muaj zaub mov noj tsawg, Repaglinide yuav tsum tau noj nyob rau hauv qhov tsawg kawg nkaus thaum pib thiab saib xyuas cov koob tshuaj. Txhawm rau tiv thaiv hypoglycemic nyob rau hauv pawg no ntawm cov neeg mob, cov koob tshuaj yuav tsum tau xaiv nrog ceev faj.

Qhov teeb meem hypoglycemic tshwm sim feem ntau yog cov kev yoog thiab cov yooj yim nres los ntawm kev ua kom tau cov carbohydrates. Nyob rau hauv cov mob hnyav, nws yuav tsim nyog los tswj cov piam thaj hauv dej khov. Qhov ntxim nyiam ntawm kev txhim kho cov tshuaj tiv thaiv yog nyob ntawm koob tshuaj, cov yam ntxwv khoom noj khoom haus, kev siv dag zog ntawm lub cev, kev ntxhov siab.

Thov nco ntsoov tias beta-blockers tuaj yeem npog cov tsos mob ntawm kev ua kom lub qog ntshav qab zib.

Thaum kho, cov neeg mob yuav tsum yauv tsum tsis txhob haus cawv, txij li thaum ethanol tuaj yeem txhim kho thiab ua kom ntev li qhov cuam tshuam hypoglycemic ntawm Repaglinide.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Tawm tsam keeb kwm yav dhau los ntawm kev siv tshuaj Repaglinide, qhov ua tau ntawm kev tsav tsheb los yog koom nrog rau lwm yam kev ua si txaus ntshai yuav tsum raug txheeb xyuas.

Yeeb tshuaj sib cuam tshuam

Cov nyhuv hypoglycemic ntawm Repaglinide ua kom zoo dua nrog kev siv tib lub sijhawm ntawm cov tshuaj monoamine oxidase inhibitors (MAOs), tsis muaj kev xaiv cov beta-blockers, angiotensin-hloov mus rau enzyme (ACE) inhibitors, salicylates, tsis siv tshuaj tiv thaiv tsis haum tshuaj (NSAIDs), octreotide, anabolic steroids.

Kev txo qis ntawm cov nyhuv hypoglycemic ntawm Repaglinide yog ua tau nrog tib lub sijhawm siv cov tshuaj hormones los tswj kev noj tshuaj rau qhov ncauj, thiazide diuretics, glucocorticosteroids (GCS), danazole, cov thyroid hormones, sympathomimetics (thaum kho lossis tshem tawm cov tshuaj no, nws yog ib qho tsim nyog yuav tau ua tib zoo saib xyuas lub xeev ntawm cov khoom noj ntawm lub cev carbohydrate).

Nrog rau kev siv sib xyaw ua ke nrog cov tshuaj uas muaj feem ntau hauv cov kua tsib, qhov ua tau ntawm kev muaj peev xwm cuam tshuam ntawm lawv yuav tsum raug txiav txim siab.

Hauv kev sib txuas nrog cov ntaub ntawv muaj nyob ntawm cov metabolism ntawm repaglinide los ntawm CYP3A4 isoenzyme, muaj peev xwm sib cuam tshuam nrog CYP3A4 inhibitors (ketoconazole, intraconazole, erythromycin, fluconazole, mibefradil), ua rau muaj kev nce ntxiv ntawm ntshav ntshav repaglinide, yuav tsum tau ua rau muaj kev cuam tshuam. Inducers ntawm CYP3A4 (suav nrog rifampicin, phenytoin) tuaj yeem txo qhov kev kub siab ntawm repaglinide hauv cov ntshav. Txij li cov degree ntawm induction tsis tau txhim tsa, kev siv tib txhij ntawm repaglinide nrog cov tshuaj no yog contraindicated.

Cov tshuaj pleev tshuaj ntawm cov tshuaj Repaglinide

Cov qauv ntawm cov qauv ua haujlwm:

Cov tshuaj ib txwm siv ntawm cov tshuaj Repaglinide los ntawm pab pawg pharmacological (hluavtaws hypoglycemic thiab lwm yam tshuaj):

• Av ‡ Q
• Adebite
• Acarbose
• Antidiab
• Arfazetin,
• Astrozone
• Bagomet,
• Betanase
• Bukarban,
• Lub Neej
• Vildagliptin,
• Vipidia,
• Galvus
• Gilemal
• Glibenez
• Glibenclamide,
• Glyclazide
• Glycon
• Glimepiride
• Glyminfor,
• Glyformin
• Glucophage,
• Guarem
• Lawj xeeb
• Diamerid,
• Diastabol,
• Eglinides
• Xelevia,
• Lycumia,
• Maninil
• Metformin
• Minidiab
• Movoglek,
• Kev Tshawb Fawb
• Onglisa,
• Pioglar
• Pioglite
• Khaws
• Rosiglitazone,
• Saxenda
• Saterex,
• Siofor
• Sofamet
• Lub xeev Statiglin,
• Trazenta,
• Lub sijhawm
• Txog rau cov,
• Rau menyuam yaus
• Forsiga
• Chlorpropamide
• Blueberry tua
• Euglucon,
• Yuglin,
• Januvius
• Yasitara.

Endocrinologist cov tswv yim

Cov tshuaj Repaglinide Kuv tau txais qee cov neeg mob uas muaj mob ntshav qab zib hom 2. Kuv xaiv cov tshuaj ib leeg rau ib leeg thiab ib hnub rau txhua tus neeg mob ib tus zuj zus thiab kho lawv, ua tib zoo saib xyuas cov ntshav qabzib hauv cov ntshav. Nws yog qhov zoo heev uas ntau tus neeg mob ntshav qab zib muaj lawv tus kheej glucometers, uas ua rau nws yooj yim rau kev txheeb xyuas qhov muaj zog ntawm glycemia thaum xaiv koob tshuaj thiab ntxiv thaum kho. Kev zam rau cov tshuaj Repaglinide zoo. Kuv tsis nco qab tias ib tus neeg mob noj nws pheej yws txog cov kev mob tshwm sim ntau dua los sis tsawg dua.

Analogues ntawm cov tshuaj Diagninid

Cov analogue yog pheej yig dua los ntawm 0 rub.

Jardins yog tshuaj txawv teb chaws rau kev kho mob ntshav qab zib hom 2. Empagliflozin nyob rau hauv cov nyiaj ntawm 25 mg rau ib ntsiav tshuaj ua raws li tsuas yog kev tiv thaiv kev tiv thaiv. Jardins muaj contraindications thiab muaj hnub nyoog txwv, yog li sab laj nrog koj tus kws kho mob ua ntej pib kev kho mob.

Cov analogue yog pheej yig dua los ntawm 59 rubles.

Chaw tsim tshuaj paus: Novo Nordisk (Denmark)
Cov Ntawv Tso Tawm:

• Tab. 1 mg, 30 pcs., Nqe txij li 175 rubles
• Tab. 2 mg, 30 pcs., Nqe txij li 219 rubles

NovoNorm yog kev npaj ntsiav tshuaj los ntawm tib pawg kws kho mob, tab sis nrog cov tshuaj sib txawv. Repaglinide siv rau ntawm no hauv qhov ntau npaum li 0.5 txog 2 mg. Cov ntsiab lus rau kev sau ntawv yuav zoo ib yam, tab sis contraindications txawv vim qhov txawv DV hauv ntsiav tshuaj, yog li ua tib zoo nyeem cov lus qhia thiab sab laj nrog koj tus kws kho mob.

Cov analogue kim dua los ntawm 2219 rubles.

Chaw tsim tshuaj paus: Yog tau meej
Cov Ntawv Tso Tawm:

• Tab. p / obol. 100 mg, 30 pcs., Nqe los ntawm 2453 rubles
• Tab. 2 mg, 30 pcs., Nqe txij li 219 rubles

Novo Nordisk (Denmark) NovoNorm yog qhov pheej yig hloov rau Forsigi. Cov tshuaj uas cuam tshuam tsuas tshuaj hauv cov tshuaj yog repaglinide. Cov tshuaj hauv 30 feeb ua rau cov tshuaj insulin ntau ntxiv hauv cov ntshav. Vim tias tsis muaj cov ntaub ntawv hais txog kev tshawb fawb qhia txog kev nyab xeeb ntawm cov tshuaj thiab kev siv tshuaj zoo hauv cov menyuam hnub nyoog, nws tsis pom zoo kom siv cov tshuaj rau cov menyuam hnub nyoog qis dua 18 xyoo. Nyob rau hauv daim ntawv ntawm kev phiv tshuaj, zawv plab thiab mob plab heev tshwm sim.

Cov analogue ntau kim dua los ntawm 1908 rubles.

Chaw tsim tshuaj paus: Yog tau meej
Cov Ntawv Tso Tawm:

• Tab. p / obol. 10 mg, 30 pcs., Nqe txij li 2142 rubles
• Tab. 2 mg, 30 pcs., Nqe txij li 219 rubles

Forsiga yog ntsiav tshuaj npaj rau kev kho mob hom 2 mob ntshav qab zib mellitus raws li dapagliflozin hauv ib koob tshuaj ntawm 5 mg. Yuav tau noj tshuaj ntxiv rau qhov ua kom ntshav qab zib thiab ua ev xaws xais. Forsigi muaj contraindications thiab muaj hnub nyoog txwv, ua tib zoo nyeem cov lus qhia ua ntej pib kev kho mob.

Nqe Repaglinide thiab muaj nyob hauv cov khw muag tshuaj ntawm lub nroog

Saib xyuas! Saum toj no yog saib lub rooj, cov ntaub ntawv yuav raug hloov pauv. Cov ntaub ntawv ntawm cov nqi thiab muaj pauv nyob rau ntawm lub sijhawm tiag tiag kom pom lawv - koj tuaj yeem siv cov ntawv tshawb (yeej ib txwm paub cov ntaub ntawv hauv kev tshawb nrhiav), thiab tseem yog tias koj xav tau tawm ib qho kev txiav txim rau tshuaj, xaiv thaj chaw hauv nroog mus tshawb lossis tshawb nrhiav tsuas yog qhib lub sijhawm cov khw muag tshuaj.

Cov npe saum toj no raug hloov kho tsawg kawg ib zaug txhua 6 teev (nws tau hloov kho rau lub 07/14/2019 thaum 11:47 - lub sijhawm Moscow). Qhia kom paub tus nqi thiab muaj tshuaj los ntawm kev tshawb (lub npov tshawb no nyob rau sab saum toj), zoo li hauv xov tooj hauv khw muag tshuaj ua ntej mus ntsib lub tsev muag tshuaj. Cov ntaub ntawv muaj nyob rau ntawm lub xaib tsis tuaj yeem siv los ua cov lus pom zoo rau kev siv tshuaj rau tus kheej. Ua ntej siv cov tshuaj, nco ntsoov sab laj nrog koj tus kws kho mob.

Repaglinide npaj

Repaglinide yog lub npe thoob ntiaj teb los ntawm cov tshuaj uas tuaj yeem txheeb tau nyob txhua qhov chaw hauv ntiaj teb. Raws li cov khoom siv ua tshuaj, repaglinide yog ib feem ntawm cov ntsiav tshuaj uas ua los ntawm ntau lub tuam txhab muag tshuaj hauv qab lawv cov npe. Cov npe lag luam tawm hauv qab no ntawm repaglinide tau sau npe nyob rau hauv Lavxias lub npe tshuaj npe:

Cov tshuaj tshiab yog Danish NovoNorm. Txhua qhov kev tshawb fawb loj tau ua nrog kev koom nrog qhov tshuaj tshwj xeeb no. NovoNorm muaj nyob rau hauv qhov ntau ntawm 0.5, 1 thiab 2 mg, hauv ib pob ntawm 30 ntsiav tshuaj. Tus nqi ntawm ib lub pob yog tsawg - los ntawm 157 txog 220 rubles. rau qhov ntau qhov sib txawv.

Diagninid thiab Iglinid yog cov generics, lossis analogues, ntawm NovoNorma. Cov tshuaj no tau sim rau tus kheej nrog tus thawj, muaj tib yam hypoglycemic effect thiab muab ntau npaum, muaj kev nyab xeeb zoo ib yam. Cov lus qhia rau cov tshuaj muaj ze li sai tau. Qhov sib txawv ntawm cov txee lub neej tau piav qhia los ntawm cov sib txawv ntawm cov koom ua ke (tsis muaj zog) cov tshuaj yeeb dej caw. Kev tshuaj xyuas ntawm cov ntshav qab zib paub meej tias tus thawj thiab analogue sib txawv tsuas yog hauv cov ntsiav tshuaj daim ntawv thiab ntim. Tus nqi ntawm Diclinid yog 126-195 rubles. rau ib pob.

Iglinid yog qhov tshiab tshaj plaws ntawm kev npaj repaglinide uas tau sau npe nyob hauv tebchaws Russia. Cov tshuaj maj mam pib tshwm sim hauv cov khw muag khoom. Tsis muaj tshuaj xyuas rau Iglinid tsis tau.

Pharmacological kev txiav txim

Repaglinide yog ib qho kev sib txuas ntawm benzoic acid. Cov tshuaj khi rau cov receptors tshwj xeeb nyob rau ntawm daim nyias nyias ntawm cov beta hlwb, thaiv cov calcium potassium, qhib cov calcium calcium, thiaj li ua rau cov tshuaj insulin tsis pub tawm.

Kev ua ntawm repaglinide tom qab noj cov tshuaj pib sai sai. Thawj qhov tshwm sim ntawm cov tshuaj yog kuaj pom tom qab 10 feeb, yog li ntawd cov tshuaj muaj peev xwm ua kom sai ua ntej noj mov. Qhov siab tshaj plaws hauv cov nkoj yog tiav tom qab 40-60 feeb, uas tso cai rau koj kom sai txo cov kab mob postprandial glycemia. Kev ua tiav sai ntawm normoglycemia tom qab noj mov yog ib qho tseem ceeb los ntawm qhov pom ntawm kev tiv thaiv kev mob vascular yam ntxwv ntawm ntshav qab zib mellitus. Cov piam thaj siab ntev, uas kav ntev los ntawm kev noj tshais kom txog thaum mus pw, txhim kho coagulation ntshav, txhawb cov ntshav txhaws, ua rau cov ntshav ua rau lub cev tsis zoo, ua rau lub cev tsis zoo hauv cov khoom tiv thaiv ntawm cov hlab ntsha, thiab ua rau muaj kev ntxhov siab tas li oxidative.

Tsis zoo li sulfonylurea derivatives (PSM), cov nyhuv ntawm repaglinide nyob ntawm glycemia. Yog tias nws tshaj li 5 mmol / l, cov tshuaj ua haujlwm ntau dua li muaj suab thaj qis. Cov tshuaj plam sai sai ua tsis tau zoo, tom qab ib nrab teev ntawm cov tshuaj pleev qhov muag tawm ntawm lub cev. Tom qab 4 teev, kev tsis txaus ntseeg ntawm cov tshuaj muaj nyob hauv cov ntshav, uas tsis muaj peev xwm cuam tshuam rau glycemia.

Cov txiaj ntsig ntawm luv luv-ua yeeb yam repaglinide:

1. Stimulated insulin ntau lawm yog ze rau ntuj li sai tau.
2. Muaj peev xwm ua tiav tau them sai rau cov ntshav qab zib.
3. Txo txoj kev pheej hmoo ntawm hypoglycemia. Thaum noj cov tshuaj repaglinide, tsis yog ib rooj plaub ntawm hypoglycemic coma tau kaw.
4. Tsis muaj cov hyperinsulinemia tsis tu ncua. Qhov no txhais tau hais tias cov neeg mob ntshav qab zib tsis ua rog hnyav.
5. Ua kom qeeb qis rau cov cell depletion thiab ntshav qab zib muaj mob.

Cov tshuaj Repaglinide yog cov tshuaj tiv thaiv hauv lub siab, 90% lossis ntau dua ntawm cov tshuaj tawm hauv cov quav, nce txog 8% ntawm qhov koob tshuaj yog pom hauv cov zis. Xws li cov kws kho mob tso cai rau siv cov tshuaj nyob rau theem lig ntawm cov ntshav qab zib nephropathy thiab lwm yam mob raum.

Kev ntsuas rau nkag

Repaglinide yog tsim rau cov neeg mob ntshav qab zib hom 2 nkaus xwb. Qhov uas yuav tsum tau ua yog lub xub ntiag ntawm ua haujlwm beta hlwb. Hauv Lavxias thiab txawv teb chaws algorithms rau kev kho mob ntshav qab zib mellitus, glinides raug cais raws li cov tshuaj cia, lawv raug kho thaum lwm cov ntsiav tshuaj txwv.

Kev taw qhia rau kev siv:

1. Raws li lwm txoj hauv kev rau cov tshuaj metformin, yog tias nws ua tsis zoo lossis ua rau muaj kev sib kis. Nws yog tsim nyog xav tias repaglinide tsis muaj qhov cuam tshuam ncaj qha rau kev nkag siab ntawm cov cell mus rau insulin, ib qho kev txo qis hauv qab zib yog ua tiav tsuas yog los ntawm kev kov yeej cov tshuaj insulin los ntawm kev nce qib hauv qib.
2. Hloov ntawm sulfonylurea derivatives, yog tias tus neeg mob tau ua rau muaj kev fab tshuaj rau ib qho ntawm cov tshuaj hauv pawg no.
3. Yuav pab ua ntu zus ntawm txoj kev kho mob, yog tias yav tas los siv tshuaj tsis ua raws li lub hom phiaj cov piam thaj. Cov kev qhia tso cai rau koj los ua ke cov tshuaj repaglinide nrog metformin thiab insulin ntev, thiazolidinediones. Nrog PSM, cov tshuaj tsis tuaj yeem siv yog tias kom tsis txhob ua kom lub hlwb ntawm cov txiav nyias.
4. Raws li kws kho mob, repaglinide ua tiav tau zoo siv rau hauv cov neeg mob ntshav qab zib uas xav tau hloov pauv hauv kev noj tshuaj ntawm cov ntsiav tshuaj: nrog rau kev ua haujlwm dhau sij hawm, hla kev noj mov, thaum lub sij hawm kev cai yoo mov.

Zoo ib yam li lwm cov tshuaj ntshav qab zib, repaglinide ua tau zoo tsuas yog ua ke nrog kev noj haus thiab kev tawm dag zog.

Thaum tsis pub rov qhib qhov ncauj tawm

Cov lus qhia rau kev siv txwv tsis pub sau tshuaj rau cov poj niam cev xeeb tub thiab lactating cov poj niam, menyuam yaus thiab cov ntshav qab zib laus dua 75 xyoo, vim tias hauv cov pab pawg ntawm cov neeg mob no kev nyab xeeb ntawm repaglinide tsis tau lees paub.

Zoo ib yam li txhua tus kab mob hauv lub qhov ncauj, siv tsis tau rau qhov mob ntshav qab zib (ketoacidosis, hyperglycemic coma thiab precoma) thiab mob hnyav (kev raug mob, kev khiav haujlwm, kev kub nyhiab lossis ntau yam, mob hnyav) - cov npe ntawm txhua yam mob hnyav. Yog tias qhov mob ntshav qab zib yuav tsum tau pw hauv tsev kho mob, kev txiav txim siab thim cov ntsiav tshuaj thiab hloov mus rau tshuaj insulin yog ua los ntawm tus kws kho mob uas koom nrog.

Txhawm rau kom cov tshuaj tuaj yeem ua haujlwm sai sai, kev ua haujlwm nyab xeeb yog qhov tsim nyog. Yog tias daim siab ua haujlwm daim siab, kho nrog repaglinide yog txwv los ntawm cov lus qhia.

Yog tias tus neeg mob ntshav qab zib mellitus yuav siv gemfibrozil rau kev kho cov lipid profile ntawm cov ntshav, NovoNorm thiab Diagninid yuav tsum tsis txhob siv tshuaj, vim tias thaum lawv tau noj ua ke, qhov siab ntawm repaglinide nyob rau hauv cov ntshav nce siab 2 lossis ntau zaus, thiab muaj ntshav qabzib ntau heev.

Nkag Tawm Cov Cai

Repaglinide yuav qaug ua ntej noj mov tseem ceeb (noj tshais, noj su, noj hmo, khoom noj txom ncauj). Yog tias cov zaub mov raug hla los yog hauv tsis muaj carbohydrates, tsis txhob siv cov tshuajCov. Raws li kev txheeb xyuas, txoj kev kho mob no yooj yim rau cov tub ntxhais hluas mob ntshav qab zib nrog kev ua lub neej nquag, thiab rau cov neeg laus laus uas tsis qab los noj mov.

Cov ntaub ntawv hais txog kev siv tshuaj:

• qhov ntau zaus ntawm kev tuaj yeem yog 2-4 zaug,
• lub sijhawm ua ntej noj mov: pom zoo - 15 feeb, tsim nyog - txog li ib nrab ib teev,
• qhov pib ib koob yog 0.5 mg rau cov ntshav qab zib tshiab uas tau tshawb pom, 1 mg thaum hloov mus rau repaglinide los ntawm lwm cov ntsiav tshuaj muaj suab thaj,
• cov koob tshuaj tau nce siab yog tias kev tswj ntshav qab zib tsis txaus. Cov txheej txheem - ua kom cov ntshav qab zib tom qab tau ntau ntxiv thiab cov ntshav qog hemoglobin,
• lub sijhawm nyob nruab nrab ntawm ntau ntxiv hauv ntau npaum li cas yog ib lim tiam,
• qhov ntau tshaj koob tshuaj ib zaug yog 4, txhua hnub 16 mg.

Raws li cov lus pom zoo niaj hnub no, kev noj tshuaj txo cov ntshav qab zib hauv qhov siab tshaj plaws yog qhov tsis xav tau, vim tias qhov no nce qhov kev pheej hmoo ntawm lawv cov kev mob tshwm sim. Yog tias 2-3 mg ntawm repaglinide tsis them nyiaj rau cov ntshav qab zib, nws raug nquahu kom ntxiv lwm yam tshuaj, thiab tsis nce ntxiv qhov ntau npaum ntawm cov tshuaj no kom ntau.

Tus kws kho mob ntawm Kev Tshawb Fawb Kev Kho Mob, Lub Taub Hau ntawm lub koom haum ntawm Diabetology - Tatyana Yakovleva

Kuv tau kawm qhov teeb meem mob ntshav qab zib tau ntau xyoo. Nws yog txaus ntshai thaum muaj coob tus neeg tuag, thiab haj yam ua rau neeg xiam vim ntshav qab zib.

Kuv maj nrawm los qhia txoj xov zoo - Endocrinological qhov chaw tshawb fawb ntawm Lavxias Academy ntawm Medical Science tau tswj hwm los tsim cov tshuaj uas kho cov mob ntshav qab zib mellitus kom zoo. Thaum lub sijhawm, cov hauj lwm zoo ntawm cov tshuaj no tau nce mus txog 98%.

Lwm qhov xov xwm zoo: Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv tau txais kev nyab xeeb qhov kev saws me nyuam ntawm cov haujlwm tshwj xeeb uas them rau cov nqi tshuaj ntau. Hauv Lavxias, neeg mob ntshav qab zib kom txog thaum lub Tsib Hlis 18 (suav nrog) tuaj yeem tau txais nws - Tsuas yog 147 rubles!

Sab sij huam

Cov kev mob tshwm sim feem ntau ntawm cov tshuaj repaglinide yog hypoglycemia. Nws tshwm sim yog tias cov kua dej ntau ntxiv tso rau hauv cov ntshav tshaj qhov tsim nyog rau kev siv cov kua nplaum nyob hauv. Kev pheej hmoo ntawm cov ntshav qog ntshav nce siab nyob ntawm tus neeg yam: cov koob tshuaj, kev noj zaub mov, kev ntxhov siab, lub sijhawm thiab siv lub cev ua ub no.

Phiv dab tsi thiab lawv cov zaus raws cov lus qhia rau kev siv:

Yeeb tshuaj sib cuam tshuam

Ua kom nce siab ntawm cov tshuaj repaglinide hauv cov ntshav lossis ncua sijhawm nws cov kev ua gemfibrozil, tshuaj tua kab mob clarithromycin thiab rifampicin, antifungals, immunosuppressant cyclosporin, MAO inhibitors, ACE inhibitors, NSAIDs, beta-blockers, salicylates, steroids, cawv.

Qhov kev txwv tsis pub muaj qhov ncauj tawm, derivatives ntawm barbituric acid thiab thiazide, glucocorticoids, antiepileptic carbamazepine, sympathomimetic tshuaj, cov thyroid hormones tsis muaj zog cov nyhuv ntawm repaglinide.

Thaum sau tshuaj thiab tso tseg cov tshuaj saum toj no, yuav tsum tau kev sab laj ntawm kws kho mob thiab kev tswj glycemic.

Repaglinide analogues

Qhov ze ntawm cov tshuaj repaglinide yog phenylalanine derivative nateglinide, cov tshuaj muaj qhov cuam tshuam tib yam sai thiab luv luv. Hauv tebchaws Russia, tsuas muaj ib cov tshuaj muaj nrog cov tshuaj no - Starlix, chaw tsim tshuaj paus NovartisPharma. Pawg rau nws yog muaj nyob rau Nyiajpoom Teb, ntsiav tshuaj lawv tus kheej - hauv Ltalis. Tus nqi ntawm Starlix yog li 3 txhiab rubles rau 84 ntsiav tshuaj.

Kev siv nyiaj txiag - kev nthuav dav ntawm PSM glibenclamide (Maninil), glycidone (Glyurenorm), glyclazide (Diabeton, Diabetalong, Glidiab, thiab lwm yam) thiab glimepiride (Amaryl, Diamerid, thiab lwm yam).

Gliptins (Galvus, Januvia thiab lawv cov analogues), tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj thiab cov tshuaj tiv thaiv muaj zog zuj zus (Bayeta, Victoza) kuj yog koom nrog cov neeg sawv cev uas txhim kho cov tshuaj insulin. Tus nqi ntawm kev kho mob nrog gliptins yog los ntawm 1500 rubles. Mimetic incretin ntau ntau kim, los ntawm 5200 rubles.

Nco ntsoov kawm! Koj puas xav tias kev tswj hwm kev noj qab haus huv ntawm cov tshuaj thiab cov kua dej yog ib txoj kev los tswj cov piam thaj kom tswj? Tsis muaj tseeb! Koj tuaj yeem soj ntsuam qhov no koj tus kheej los ntawm kev pib siv nws. nyeem ntxiv >>

Cov lus sib xyaw thiab kev piav qhia ntawm cov tshuaj

Txhua lub ntsiav tshuaj muaj 0.5 lossis 1 mg ntawm cov tshuaj tiv thaiv ntawm micronized repaglinide, ntxiv nrog cov khoom xyaw: calcium calcium phosphate anhydrous, colloidal silicon dioxide, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl cellulose, meglumine, magnesium stearate, dyes.

Round biconvex ntsiav tshuaj tuaj yeem txheeb xyuas los ntawm kev txaug nrog cov lej uas qhia tias ntau npaum li cas. Nrog rau qhov cim ntawm 0.5, lawv yog dawb, nrog 1 mg - lavender lossis daj. Sab nraub qaum koj tuaj yeem pom tus tsiaj ntawv luv luv RP, J thiab lwm tus. 10 ntsiav tshuaj yog pob nyob rau hauv blisters. Yuav muaj ob peb daim phiaj no nyob hauv ib lub thawv ntawv thawv.

Muaj tshuaj kws kho mob muab tauCov. Tus nqi rau Repaglinide yog qhov kev siv nyiaj ntau: 30 ntsiav tshuaj ntawm 2 mg hauv Moscow tuaj yeem yuav rau 200-220 rubles. Lawv tso tshuaj rau hauv Denmark, Israel, Is Nrias teb thiab lwm lub tebchaws, suav nrog thaj chaw tom qab Soviet.

Lub txee lub neej ntawm cov tshuaj, tshaj tawm los ntawm cov chaw tsim khoom, yog nyob nruab nrab 3 xyoos. Cov tshuaj tsis tas yuav tshwj xeeb rau kev khaws cia. Tom qab lub sijhawm tau teev tseg, cov ntsiav tshuaj yog raug rau pov tseg.

Cov yam ntxwv ntawm Pharmacological

Cov nyhuv tseem ceeb ntawm cov tshuaj yog hypoglycemic. Cov tshuaj thaiv ATP-dependant potassium cov chaw nyob hauv lub b-cell membrane, pab txhawb lawv txoj kev tso dag thiab tso cov calcium. Yog li, cov lus zais cia tsim kev cuam tshuam cov tshuaj hormones.

Cov kev tshawb fawb soj ntsuam tseem tsis pom muaj mutagenic, teratogenic, carcinogenic cov teebmeem nyob rau hauv cov tsiaj thiab lub cev tsis taus.

Repaglinide yog nqus sai thiab ua tiav ntawm cov hnyuv, ncav nws qhov siab tshaj plaws hauv cov ntshav hauv ib teev.

Yog hais tias noj nrog zaub mov noj, Cmax raug txo qis li 20%. Qhov kev kub siab ntawm cov tshuaj poob tawm sai thiab tom qab 4 teev nce mus txog qhov cim tsawg kawg. Cov tshuaj khi rau cov ntshav plasma protein yuav luag tiav (ntawm 98%) nrog kev ntsuas kev noj qab haus huv ntawm 56%. Biotransformation nrog kev tsim cov inert metabolites tshwm sim hauv lub siab.

Cov tshuaj tau tshem tawm nyob rau hauv 4-6 teev nrog ib nrab-lub neej ntawm 1 teev. Thaum 90% nws kis tau los ntawm cov kab mob txoj hauv plab, txog 8% yog tawm ntawm lub raum.

Leej twg yog tus Repaglinide rau?

Cov tshuaj yog tsim los tswj cov ntshav qab zib hom 2 yog tias kev hloov pauv ntawm kev ua neej (noj zaub mov kom tsawg, ua kom cov leeg nqaij txaus, tswj lub xeev) tsis muab glycemic tswj tiav.

Nws yog qhov tsim nyog los siv glinide hauv kev kho mob nyuaj nrog metformin thiab thiazolidinediones, yog tias monotherapy, kev noj haus kho mob thiab kev ua kom lub cev tsis ua kom tau qhov txiaj ntsig yam xav tau.

Rau leej twg Repaglinide yog contraindicated

Ntxiv nrog rau kev txwv ib txwm muaj (ib leeg tsis kam lees, cev xeeb tub, menyuam yaus, pub niam mis), cov tshuaj yog contraindicated:

• Tus mob ntshav qab zib hom 1,
• Nrog cov ketoacidosis uas mob ntshav qab zib,
• Nyob rau hauv lub xeev ntawm coma thiab precoma,
• Yog tias tus neeg mob tau mob lub raum thiab lub siab ua haujlwm tsis zoo,
• Hauv cov xwm txheej uas yuav tsum tau hloov chaw mus nyob ib ntus rau insulin (mob, mob, phais, phais).

Tshwj xeeb kev saib xyuas yuav tsum tau them rau kev sau ntawv rau glinides rau kev haus cawv, cov neeg muaj mob raum, thiab kub taub hau.Cov. Muaj kev txwv lub hnub nyoog: tsis txhob muab tshuaj rau cov neeg mob ntshav qab zib ua ntej 18 thiab tom qab 75 xyoo vim tsis muaj pov thawj rau cov pawg no.

Txoj kev ntawm daim ntawv thov

Txog kev rov ua dua, cov lus qhia rau kev siv pom zoo kom noj ib ntsiav tshuaj ua ntej (ua ntej noj mov). Tus kws kho mob yuav xaiv cov koob tshuaj uas tsim nyog rau kev pom zoo glycemic nyob rau hauv raws li cov txiaj ntsig ntawm kev tshuaj ntsuam, theem ntawm tus kabmob, concomitant pathologies, hnub nyoog, tus neeg lub cev tawm tsam cov av nplaum.

Txhawm rau kom meej meej cov tshuaj kho mob tsawg kawg nkaus, nws yog ib qho tsim nyog yuav tsum tswj cov qab zib thiab tom qab muaj suab thaj hauv tsev thiab hauv chav kuaj mob. Thaum kho cov kev cai ntawm cov tshuaj, lawv kuj tau coj los ntsuas ntawm glycated hemoglobin.

Kev tshuaj xyuas yog tsim nyog los txheeb xyuas qhov tseem ceeb thawj thiab theem nrab tsis ua haujlwm, thaum theem ntawm glycemia poob qis dua li qub thaum pib ntawm chav kawm lossis tom qab lub sijhawm pib kho.

Lub sijhawm rau noj cov tshuaj repaglinide tsis nruj: 15-30 feeb ua ntej noj mov lossis tam sim ntawd thaum pib noj mov. Yog tias muab khoom noj txom ncauj ib qho ntxiv (lossis dhia dua), tom qab ntawd muab lwm cov ntsiav tshuaj ntxiv (lossis dhia dua).

Yog tias cov ntshav qab zib tsis tau txais cov tshuaj muaj suab thaj, qhov pib ntawm cov av nplaum yuav tsum muaj qis li 0.5 mg ua ntej txhua pluas noj. Yog tias nws hloov mus rau repaglinide nrog lwm cov tshuaj tiv thaiv kev mob ntshav qab zib, koj tuaj yeem pib nrog 1 mg ua ntej txhua pluas noj.

Nrog rau kev kho mob, kev pom zoo kom noj tshuaj tsis dhau 4 mg ua ntej noj mov loj. Kev noj haus txhua hnub ntawm cov av nplaum yuav tsum tsis pub tshaj 16 mg.

Nrog rau kev kho mob nyuaj, qhov koob tshuaj ntawm repaglinide tsis hloov, thiab cov cai ntawm lwm yam tshuaj raug xaiv nyob rau hauv raws li kev nyeem ntawv ntawm glucometer thiab kev kho mob yav dhau los.

Yam tsis tau xav txog

Ntawm cov kev mob tshwm sim hnyav tshaj plaws ntawm cov glinids, mob ntshav qab zib yog qhov txaus ntshai tshaj plaws. Thaum sau daim ntawv yuav tshuaj, tus kws kho mob yuav tsum qhia cov neeg mob rau nws cov tsos mob thiab cov hau kev ntawm kev pabcuam ua ntej thiab kev pabcuam tus kheej rau tus neeg raug mob.

Ntawm lwm yam xwm txheej tsis xav tau:

1. Dyspeptic mob
2. Ua txhaum ntawm cov lus sib dhos ntawm lub plab hnyuv,
3. Cov tawv nqaij ua xua,
4. Kev ua haujlwm ntawm lub siab ua daim ntawv transistor nce rau hauv transaminase kev ua haujlwm,
5. Kev pom kev puas vim yog qhov sib txawv ntawm qib glycemic.

Qhia Txog Kev Sib Koom Tes Nrog Tshuaj

Nrog rau txoj kev siv hluav taws xob sib xyaw nrog β-blockers, ACE inhibitors, chloramphenicol, dej cawv, MAO inhibitors, tsis ncaj NSAID anticoagulants, probenecid, salicylates, sulfonamides, anabolic steroids, cov txiaj ntsig ntawm av nplaum nce ntxiv.

Kev tswj hwm tib lub sijhawm ntawm cov tshuaj repaglinide thiab calcium channel blockers, corticosteroids, thiazide diuretics, isoniazid, nicotinic acid nyob rau hauv cov tshuaj noj tsis raws qauv, estrogen (muaj nyob hauv cov tshuaj tiv thaiv), sympathomimetics, phenothiazines, phenytoin, cov thyroid hormones txo cov peev xwm ntawm glinides.

Pab nrog overdose

Tus mob no tuaj yeem lees paub los ntawm:

• Kev tswj tsis tau yam yus xav tau
• Qaug zog,
• Tawv nqaij daj,
• Tachycardia,
• Mob leeg pob txha
• Tawm hws ntau,
• Tsaus muag, tsis nco qab.

Kev pab rau cov neeg raug tsim txom yog tsos mob thiab txhawb nqa. Yog tias cov ntshav qab zib tau nco qab, nws yuav tsum tau muab cov carbohydrates sai sai (qab zib, qab zib), tom qab ib pliag, lub cev tau khov kho nrog cov piam thaj yuav tsum rov ua dua, vim tias muaj qhov ua tau ntawm rov mob.

Yog hais tias tus neeg mob tsis muaj cov cim ntawm kev nco qab, cov kua nplaum tov (50%) tau txais koob tshuaj, txhawm rau kom muaj glycemic theem siab tshaj 5.5 mmol / l, ib qho dej ntws tawm tau nrog 10% kua nplaum tov. Thaum muaj mob hnyav, yuav tsum tau pw hauv tsev kho mob sai.

Cov lus pom zoo ntxiv

Kev saib xyuas tshwj xeeb (tswj kev yoo thiab tom qab qab zib, kev ua haujlwm ntawm lub hom phiaj cov kabmob) thaum sau cov av nplaum yog qhov yuav tsum tau ua los ntawm cov neeg mob ntshav qab zib nrog lub raum thiab hepatic pathologies. Lawv yuav tsum paub tias yog tias muaj kev ua txhaum ntawm kev noj tshuaj thiab kev coj tshuaj, siv cawv, noj zaub mov kom tsawg, ua kom lub cev rog dhau, kev ntxhov siab, nws yog qhov tsim nyog los kho lub koob tshuaj repaglinide, vim tias cov xwm txheej zoo li no tuaj yeem ua rau ntshav qab zib tsawg.

Hauv kev sib txuas nrog kev mob tshwm sim loj, yuav tsum tau saib xyuas thaum tsav tsheb thiab cov cuab yeej tsim khoom, phom sij, thaum ua haujlwm ntawm qhov siab, thiab lwm yam.

Txhawm rau tiv thaiv hypoglycemia, cov neeg mob ntshav qab zib nrog cov tsos mob tsis muaj zog ntawm kev tuaj yeem ua ntej, nrog rau cov neeg uas muaj tej yam xwm txheej zoo li no tsis yog qhov tsis tshua pom tshwm sim, koj yuav tsum tau ceev faj ntxiv, ntsuas kev pheej hmoo thiab nws qhov tuaj yeem.

Repaglinide - analogues

Repaglinide tso tawm nyob rau hauv ntau lub npe lag luam: NovoNorm, Diclinid, Iglinid, Repodiab.

Raws li ATX txoj cai ntawm qib 4, cov tshuaj tiv thaiv kab mob hauv Bayeta txhaj tshuaj nrog cov nquag tiv thaiv exenatide thiab Viktoza nrog cov tshuaj sib xyaw nrog liraglitide coincide nrog nws.

Qee tus neeg mob ntshav qab zib suav tias lawv tus kab mob yog qhov tsis txaus ntseeg, tsis paub tias tus kab mob insidious no tuaj yeem xa mus rau lwm lub ntiaj teb tam sim.

Repaglinide yog ib tus kabmob hypoglycemic loj, kev sim ua tshuaj rau tus kheej thiab hloov pauv yog qhov muaj kev phom sij rau kev noj qab haus huv, vim tias cov tshuaj tau nrawm nrawm, nrog rau cov npe loj ntawm contraindications thiab phiv. Yog tias koj tau kuaj mob ntshav qab zib mellitus, koj yuav tsum tau kho mob hnyav, tsis tas yuav ncua sijhawm tom qab.

Cov kev xaiv kho mob rau hom ntshav qab zib hom 2 tuaj yeem pom ntawm video.