I-Repaglinide

I-Repaglinide

I-Repaglinide, isidakamizwa esinamandla esisetshenziswa ukulawula amazinga kashukela egazini, isibe yimpilo yabantu abaningi abanaso thayipha 2 sikashukela. Lo muthi usiza umzimba ukuthi ukhiqize i-insulin eningi, okuvumela ukulawulwa okungcono kwe-glucose. Ukuqonda indlela yokusebenzisa i-repaglinide ngokuphepha kubalulekile kulabo abathembele kuyo ukuze balondoloze impilo yabo kanye nezinga lempilo. Le bhulogi ihlose ukuhlinzeka ngolwazi olubanzi mayelana ne-repaglinide, ehlanganisa ukusetshenziswa kwayo, umthamo, kanye nemiphumela engemihle engase ibe khona.

Iyini i-Repaglinide?

I-Repaglinide isidakamizwa esinqunyelwe odokotela ukuphatha uhlobo 2 sikashukela mellitus. Iyingxenye yezidakamizwa ze-antihyperglycemic futhi isiza ukwehlisa ushukela wegazi. I-Repaglinide ishukumisa amanyikwe ukuba akhiphe i-insulin, ihomoni esiza umzimba ukuba usebenzise i-glucose yawo ukuze uthole amandla. Lo muthi ubophezela kuma-receptors athile kumaseli we-pancreatic beta, okuwenza avale iziteshi ze-potassium ezincike ku-ATP. Ngenxa yalokho, ukukhiqizwa kwe-insulin kuyanda, okusiza ekulawuleni amazinga kashukela egazini.

Ukusetshenziswa kwe-Repaglinide

Odokotela ngokuyinhloko banikeza i-repaglinide ukwelapha uhlobo 2 sikashukela. Lo muthi onamandla usiza ukulawula amazinga kashukela egazini ezigulini imizimba yazo engayisebenzisi i-insulin ngendlela evamile. I-Repaglinide ivuselela ama-pancreas ukuthi akhulule i-insulin, yehlisa inani le-glucose egazini. Kuyinzuzo ekulawuleni ukukhuphuka koshukela wegazi ngemuva kokudla. Ngokuthatha i-repaglinide njengoba kushiwo, kanye nokwenza izinguquko endleleni yokuphila nokuqapha njalo ushukela wegazi, iziguli zingakwazi ukulawula ngempumelelo izimpawu zazo zesifo sikashukela.

Ungawasebenzisa kanjani amaphilisi e-Repaglinide

• Iziguli zithatha amaphilisi e-repaglinide ngomlomo ngaphambi nje kokudla. Kufanele banikeze umuthi cishe imizuzu engama-30 ngaphambi kokudla okuhlosiwe kodwa kungakedluli ngaphambi nje kokudla. Uma umuntu eqa ukudla, kufanele futhi eqe umthamo ohambisanayo we-repaglinide. 
• Odokotela banganyusa kancane umthamo ngokuya ngempendulo yesiguli ku-repaglinide. Ukulungiswa komthamo ngokuvamile kubuyekezwa ngemva okungenani kweviki elilodwa. Iziguli kufanele zilandele ilebula yemithi kadokotela ngokucophelela futhi zithintane nodokotela wazo uma zinemibuzo.
• Ukuthatha i-repaglinide ngendlela eqondisiwe kubalulekile, ngaphandle kokuthatha okungaphezulu noma okungaphansi kwalokho okunqunyiwe. 
• Iziguli kufanele ziqhubeke nokuthatha imithi ngisho noma zizwa kahle futhi zingayeki ngaphandle kokubonisana nodokotela wazo.

Imiphumela Emibi Yezibhebhe ze-Repaglinide

I-Repaglinide ingadala imiphumela engafuneki kanye nezinzuzo ezihlosiwe, njenge:

• Imiphumela emibi evamile ihlanganisa ukukhathazeka, umbono ongenalutho, ukugodola, ukujuluka okubandayo, ukudideka, isiyezi, ukushaya kwenhliziyo okusheshayo, ikhanda elibuhlungu, indlala eyandayo, isicanucanu, nokukhathala okungajwayelekile. 
• Kancane kancane, iziguli zingase zibe nobuhlungu besinye, umchamo oguqubele, noma iqolo eliphansi. 
• Eminye imiphumela engemihle, njengokuqaqamba komzimba, ukuminyana kwesifuba, noma ikhala eliminyene, ingase yehle njengoba umzimba ujwayela imithi. 
• Kwesinye isikhathi, imiphumela emibi kakhulu ingenzeka, njengokuqhuma kwesikhumba, umchamo omnyama, noma ukuphuzi kwamehlo noma isikhumba. Lezi zimpawu zidinga ukunakekelwa kwezokwelapha ngokushesha. 
• Iziguli kufanele zithintane nodokotela wazo uma noma yimiphi imiphumela emibi iqhubeka noma ibakhathazayo. Kubalulekile ukuqapha izimpawu zoshukela wegazi ophansi, umphumela ongathi sína we-repaglinide.

Ukuqapha

Iziguli kufanele zithathe i-repaglinide kuphela lapho zinqunywe udokotela futhi zilandele umthamo onqunyiwe we-repaglinide. 

• Ukulungiswa Kwethamo: Izimo ezithile ezicindezelayo njengomkhuhlane, ukuhlukumezeka, ukutheleleka, noma ukuhlinzwa kungashintsha inani elidingekayo lemithi yesifo sikashukela. Iziguli kufanele zixoxe ngalezi zimo nodokotela wazo ukuze balungise imithi yabo uma kunesidingo. 
• Gwema Imisebenzi Ethize: I-Repaglinide ingathinta ukuqapha nokuxhumana, ikakhulukazi uma ushukela wegazi wehla kakhulu. Iziguli kufanele zigweme ukushayela noma imisebenzi edinga ukuqapha kuze kube yilapho ziqonda ukuthi i-repaglinide ibathinta kanjani. 
• Ukulawulwa Kwezifo: Ukufunda ukuvimbela, ukuqaphela, nokuphatha amazinga kashukela aphansi naphezulu kubalulekile. 
• Dala Iphrofayela Yakho Yezokwelapha: Kubalulekile ukwazisa odokotela ngazo zonke izimo zezempilo nemithi, okuhlanganisa imikhiqizo etholakala ezitolo kanye nezithasiselo.

Isebenza kanjani ithebhulethi ye-Repaglinide

I-Repaglinide ilawula amazinga kashukela egazini ngokugqugquzela ukukhululwa kwe-insulin kumanyikwe. Ibophezela kuma-receptors kumaseli e-beta e-pancreatic, okwenza iziteshi ze-potassium ezincike ku-ATP zivale. Lesi senzo sidala ukukhiqizwa kwe-insulin, esiza ukunciphisa i-glucose egazini.
Ukusebenza komuthi kuncike ekusebenzeni kwamaseli e-beta kanye nokuba khona kweglucose. I-Repaglinide isebenza kahle kakhulu kumazinga kashukela aphakathi (3 kuya ku-10 mmol/L) futhi ayikukhulisi ukukhululwa kwe-insulin ekugxilweni kweglucose ephezulu (ngaphezu kuka-15 mmol/L).
I-Repaglinide isebenza ngokushesha, nengxenye yempilo engaphansi kwemizuzu engama-60. Imuncwa ngokushesha futhi ithinta kakhulu amazinga eglucose we-postprandial. Ucwaningo lukhombisa ukuthi ingehlisa ushukela we-postprandial cishe ngo-5.8 mmol/L kanye ne-glucose yokuzila ngo-3.1 kuya ku-3.4 mmol/L.
Umuthi ukhethwa kakhulu kumaseli e-beta e-pancreatic futhi awuthinti amathambo noma imisipha yenhliziyo noma izicubu zegilo. Ayisebenzi futhi iphuma esibindini.

Ngingathatha i-Repaglinide Neminye Imithi?

Iziguli kufanele zazise udokotela wazo ngemithi yazo, okuhlanganisa incwadi kadokotela, ezitolo, amavithamini, nemikhiqizo yamakhambi. I-Repaglinide isebenzisana nezidakamizwa eziningi, njenge: 

• I-Clopidogrel
• I-Cyclosporine
• Gemfibrozil 
• I-Hydroxychloroquine
• I-Ketoconazole
• I-Levofloxacin
• I-Metformin
• I-Nifedipine
• Eminye imithi yesifo sikashukela, ikakhulukazi i-insulin
• Phenobarbital 
• Rifampin
• I-Simvastatin

Iziguli kufanele zithintane nodokotela wazo ngaphambi kokuqala noma ukuyeka eminye imithi ngenkathi zithatha i-repaglinide. Bangase badinge ukuqapha amazinga kashukela eduze kakhulu ngalezi zikhathi. 

Ulwazi Lomthamo

Odokotela banquma i-repaglinide njengesengezo ekudleni nasekuzivocavoceni ezigulini ezinesifo sikashukela soHlobo II. Umthamo wokuqala uncike kumazinga e-HbA1c esiguli. 
Nge-HbA1c <8%, odokotela batusa u-0.5 mg ngaphambi kokudla ngakunye. 
Ku-HbA1c ≥8%, umthamo usukela ku-1-2 mg ngaphambi kokudla. 
Ibanga lomthamo ngu-0.5-4 mg ngaphambi kokudla, ngomthamo omkhulu we-16 mg ngosuku. 
Odokotela bangaphinda kabili umthamo ufike ku-4 mg ngokudla ngakunye kuze kube yilapho isiguli sesizuze ukulawulwa kwe-glycemic okufiselekayo. Ngemva kokulungiswa ngakunye komthamo, balinda okungenani isonto elilodwa ukuze bahlole impendulo yabo.

Isiphetho

I-Repaglinide inomthelela omkhulu ekulawulweni kwesifo sikashukela sohlobo 2 ngokulawula amazinga kashukela egazini ngempumelelo. Lo muthi uvuselela ukukhululwa kwe-insulin kumanyikwe, usize iziguli ukuthi zilawule amazinga azo eglucose, ikakhulukazi ngemva kokudla. Ukuqonda ukuthi isetshenziswa kanjani i-repaglinide ngokuphepha, okuhlanganisa ukudosa ngendlela efanele, imiphumela engemihle ye-repaglinide engaba khona, kanye nezinyathelo zokuphepha ezibalulekile, kubalulekile ezigulini ukuze zizuze kakhulu kulokhu kwelashwa.
Kulabo abanqunyelwe i-repaglinide, ukulandela imiyalelo kadokotela eduze nokuqapha njalo amazinga kashukela egazini kubalulekile. Ngokusebenzisa i-repaglinide njengengxenye yesu eliphelele lokulawula isifo sikashukela, elihlanganisa ukudla okunempilo nokuzivocavoca umzimba njalo, iziguli zingathuthukisa impilo yazo yonke futhi zinciphise ingozi yezinkinga ezihlobene nesifo sikashukela. 

Ama-FAQ:

1. I-repaglinide isetshenziselwa ini ngokuyinhloko?

I-Repaglinide yelapha isifo sikashukela sohlobo 2 ngokulawula amazinga kashukela egazini. Ivuselela ukukhishwa kwe-insulin kuma-pancreas, yehlisa ushukela wegazi.

2. Ubani odinga ukuthatha i-repaglinide?

Iziguli ezinoHlobo lwe-2 DM, lapho ushukela wegazi ungalawulwa ngokudla nokuzivocavoca kuphela, zingase zidinge i-repaglinide. Ayisetshenziselwa isifo sikashukela sohlobo loku-1 noma i-ketoacidosis yesifo sikashukela.

3. Ingabe kubi ukusebenzisa i-repaglinide nsuku zonke?

Ukusetshenziswa kwansuku zonke kwe-repaglinide kuphephile uma kunqunywe udokotela. Thatha izikhathi ezine ngosuku ngaphambi kokudla, weqa imithamo uma ukudla kweqiwe.

4. Ingabe i-repaglinide iphephile?

I-Repaglinide ngokuvamile iphephile uma isetshenziswa njengoba kuyalelwe. Kodwa-ke, kungadala i-hypoglycemia. Iziguli kufanele ziqaphe amazinga kashukela futhi zazi ukuthi zingawulawula kanjani ushukela wegazi ophansi.

5. Ubani Ongakwazi ukusebenzisa i-repaglinide?

Abantu abanesifo sikashukela sohlobo loku-1, i-ketoacidosis yesifo sikashukela, ukungasebenzi kahle kwesibindi, noma labo abasebenzisa i-insulin akufanele bathathe i-repaglinide. Iphinde iphikiswe nge-gemfibrozil noma i-clopidogrel.

6. Ingabe i-repaglinide iphephile ezinso?

I-Repaglinide ibhekwa njengephephile ezigulini ezine- isifo sezinso uma kuqhathaniswa ne-metformin ne-sulfonylureas. Nokho, kungase kudingeke ukulungiswa komthamo.

7. Ngingakwazi ukuthatha i-repaglinide ebusuku?

I-Repaglinide kufanele ithathwe ngaphambi kokudla, hhayi ebusuku, ngaphandle uma idliwe sekwephuzile. Yenzelwe ukulawulwa kwe-glucose ye-prandial.

8. Yisiphi isikhathi esingcono kakhulu sokuthatha i-repaglinide?

Thatha i-repaglinide imizuzu engama-30 ngaphambi kokudla ngakunye, kuze kube izikhathi ezine ngosuku. Yeqa umthamo uma weqa ukudla.