I-Thiazolidinediones yimiyeza yomlomo eyanceda ukunciphisa iswekile yegazi kwi- type 2 yeswekile . Ukongeza kokutya okunempilo kunye nokuzivocavoca, yindlela enye yokulawula umlinganiselo weshukela wegazi. Bayaziwa nangokuthi i-glitazones.
E-US, i-thiazolidinediones ekhoyo ngoku iquka i-Actos (pioglitazone), i-Avandia (i-rosiglitazone), kunye ne-Avandamet (i-rosiglitazone kunye ne-metformin).
I-FDA iphakanyisile imithintelo yemimiselo kwi-rosiglitizone ngo-2013 emva kokugqiba ubungqina obutsha kubonisa akukho mngcipheko wokuhlaselwa kwintliziyo, kodwa ukuvalwa kwezinto kuhlala eYurophu.
IiDos neDont
I-Thiazolidinediones inceda ukunciphisa ukunyanzelwa kwe-insulin kwiiseli, ukuphucula indlela umzimba uphendula ngayo kwi-insulin. Zithathwa ngomlomo kanye okanye kabini imihla ngemihla. Ukongezelela, zinokusetyenziswa kuphela, kunye nezinye iipilisi, okanye nge-insulin. I-Thiazolidinediones ayifaki indawo ye-insulin emzimbeni okanye ayishukumisela umzimba ukuba yenze i-insulin eyongezelelweyo. Azingathathi ukutshintsha ukutya okunempilo ugqirha ugunyazisa nokuba.
Imbali yokuSebenza
Ukususela ekupheleni kwee-1990, i-thiazolidinediones isetyenziselwe ukuphatha uhlobo lwe-2 lweswekile. Isilwanyana sokuqala kule klasi, uRezulin, sisusiwe kwimakethi yase-US ngenxa yeengxaki ezingabonakaliyo kodwa ezinzulu zesibindi. Ezinye iingxelo ziye zaphakamisa iingxakini malunga nomngcipheko wokwehluleka kwentliziyo kwizigulane ezithatha i-Avandia.
Ezinye iingxelo ziphakanyise ingozi yokuhlaselwa kwentliziyo kunye ne-thiazolidinediones, nangona le nxu lumano lungaqinisekanga.
I-FDA yalela, ngo-2006, ukuba iilebula zamachiza ze-Avandia zilumkisa ngengozi enkulu yokuhlaselwa intliziyo kunye nentlungu yesifuba kwezinye izigulane. Ukusetyenziswa kwe-Avandia kwehla kakhulu emva kokukhutshwa kwezixwayiso zokuqala.
Ngo-2010 i-FDA yayinqumle imimiselo emitsha ye-Avandia kubantu kuphela ababenako ukulawula igazi labo ngegazi kunye nesinye isilwanyana okanye abazange bakwazi ukuthatha i-Actos.
Ngomhla ka-2013, iziphumo ze-RECORD esilingo sonyango asifumani nengozi yokuhlaselwa intliziyo nge-Avandia (rosiglitazone). Ngenxa yoko, ngo-2013 i-FDA iphakamise imingcele eyayibeka kwi-Avandia. Ngomhla we-16 kuDisemba, i-FDA iphelile iCandelo loVavanyo lweNngcipheko lokuNciphisa iMingeni ye-rosiglitazone ene-medication, ekugqibeleni ukuba iingeniso ziphezulu ngaphezu kweengozi.
Nangona kunjalo, i-Yurophu yamayeza eYurophu yamisa ukuthengisa kwe-rosiglitazone ngo-2010 kwaye ii-Arhente zeeMicrosoft zaseJamani kunye neJamani zinqamamisela ukusetshenziswa kwe-pioglitazone (Actos) ngo-2011.
Iimpawu eziPhakathi kunye neengozi
Iziphumo eziqhelekileyo ziquka ukufumana ubunzima, izifo eziphezulu zokuphefumula, ukusulelwa kwe- sinus , ukuphathwa kwentloko, kunye ne-anemia. Iziphumo ezibi kakhulu zibandakanya ukugcinwa kwamanzi, ukukhubazeka kwentliziyo, ukufumana ubunzima, kunye nentlungu yomzimba. Ezinye iziphumo ezichaphazelekayo zingabandakanya iintloko, i-cholesterol ephezulu, amathambo abuthathaka, iingxaki zamehlo kunye nemihlathi.
Nangona kungabikho ubungqina obukhoyo obonisa ukuba i-Actos okanye i-Avandia ibangele iingxaki zesibindi, kulungile ukugcina isohlo ngenxa yeempawu ezifana neentlanzi, ukuhlanza, isisu, isisu, ukuphelelwa kwesidlo, i-jaundice (ukuluphuza kwesikhumba kunye namehlo), kwaye umchamo omnyama.
Ngubani ongafanele asebenzise i-Thiazolidinediones
Abantu abane-diabetes yohlobo lwe-1 (abafuna i-insulin rhoqo injections), ukungaphumeleli kwintliziyo, okanye isifo sesibindi akufanele sisebenzise i-thiazolidinediones. Abantwana kunye nabafazi abakhulelweyo okanye abahlengikazi kufuneka baphephe ukusebenzisa le myeza. Abantu abaneengxaki zamehlo okanye zethambo bafanele bathethe nababoneleli bezempilo ngaphambi kokuba bathathe i-thiazolidinediones.
Okunye "I-Label ye-Off-Label"
I-Actos inokunceda ekuphatheni i-cholesterol ephezulu. I-Thiazolidinediones inokukunceda nokwandisa i-ovulation kunye nokuzala kwi-polycystic ovary syndrome.
Yintoni Esingazi Ngayo NgeTaazolidinediones
I-Thiazolidinediones kufuneka ithathwe rhoqo imihla.
Baya kuthatha iinyanga ezintathu ukuya kusebenza ngokupheleleyo. Ukuba umntu uhlangabezana nayo nayiphi na imiphumo emibi, ngokukodwa ukuvuvukala, ukuzuza ngokukhawuleza, ukuphefumula, ukunyamezela intliziyo, ukutshintsha kwindoda okanye amathambo aphukileyo, xelela umboneleli wezempilo ngokukhawuleza.
Nangona kunjalo, abantu abanesifo sikashukela, mabafanele bayeke ukusebenzisa iyeza zabo ngaphandle kokuba baxelelwe ukuba benze njalo. Kubalulekile ukubona ugqirha ekunyamekelweni okufutshane xa uthatha i-thiazolidinediones. Oku kufuneka kufake ukuhlolwa kweeshukela zegazi, iimvavanyo zentsholongwane, kunye nokuhlolwa kwamehlo.
Imithombo:
I-Mahaffey, uKenneth W .; Hafley, Gail; Dickerson, Sheila; Burns, Shana; Tourt-Uhlig, uSandra; Omhlophe, uJennifer; Newby, uL. Kristin; Butjda, Michel; McMurray, uJohn; Bigelow, uRobert; Ekhaya, uFilipu D; Lopes, uRenato D. (2013). "Iziphumo zokuhlaziywa kwakhona kwemiphumo ye-cardiovascular in trial RECORD". I-American Heart Journal 166 (2): 240-249.e1.
Drazen, MD, Jeffrey M., uStefano Morrissey, Ph.D., noGregory D. Curfman, MD "URosiglitazone-Iyaqhubeka Nokungaqiniseki Ngokukhuseleko." I-New England Journal of Medicine. 357 (2007): 63-64.
I-FDA yoKhuseleko loLuxhumo lweMithi: I-FDA idinga ukususwa kweminye imimiselo yokuhambisa i-rosiglitazone ene-diabetes. FDA Newsroom. 11/25/2013. US Food and Drug Administration.
UDavid K. McCulloch, MD. "I-Thiazolidinediones ekwenzeni unyango wesifo sikashukela," umhla wama-17, 2015. I-UpToDate.