I-Thiazolidinediones imithi yomlomo esiza ukwehlisa ishukela legazi ngohlobo lwesifo sikashukela . Ngaphezu kokudla okunempilo nokuzivocavoca, enye indlela yokulawula amazinga kashukela egazini. Zaziwa nangokuthi glitazones.
E-US, i-thiazolidinediones okwamanje iyatholakala ihlanganisa i-Actos (pioglitazone), i-Avandia (i-rosiglitazone), kanye ne-Avandamet (i-rosiglitazone ne-metformin) yezidakamizwa.
I-FDA iphakanyisiwe imikhawulo yemithi e-rosiglitizone ngo-2013 ngemuva kokuphetha ubufakazi obusha obonisa ukuthi akukho nengozi yokuhlasela kwenhliziyo, kodwa ukuvinjelwa kuhlale kukhona eYurophu.
Ama-Dos no-Dont
I-Thiazolidinediones isiza ekunciphiseni ukumelana kwe-insulin emangqamuzaneni, ngcono indlela umzimba ophendula ngayo kwi-insulin. Zijwayele ukuthathwa ngomlomo kanye noma kabili ngosuku. Ngaphezu kwalokho, zingasetshenziswa zodwa, nezinye amaphilisi, noma nge-insulin. I-Thiazolidinediones ayishintshi i-insulin emzimbeni futhi ayishukumisi umzimba ukuba udale i-insulin eyengeziwe. Awuhlosiwe ukufaka esikhundleni sokudla okunempilo udokotela uncoma noma.
Umlando Wokusetshenziswa
Kusukela ngasekupheleni kweminyaka yama-1990, i-thiazolidinediones isetshenziselwe ukwelapha uhlobo lwesifo sikashukela sohlobo lwe-2. Isidakamizwa sokuqala kuleli klasi, u-Rezulin, sisusiwe emakethe yase-US ngenxa yezinkinga ezingavamile kepha ezinzulu zesibindi. Eminye imibiko iye yaveza ukukhathazeka mayelana nengozi eyengeziwe yokwehluleka kwenhliziyo kwiziguli ezithatha i-Avandia.
Eminye imibiko isikisela ukuthi ingozi eyengeziwe yokwehla kwenhliziyo nge-thiazolidinediones, nakuba lesi sixhumanisi sihlala singavunyelwe.
I-FDA yalela, ngo-2006, ukuthi izidakamizwa zokubhala izidakamizwa ze-Avandia zixwayisa ngengozi enkulu yokuhlaselwa inhliziyo kanye nobuhlungu besifuba kwezinye iziguli. Ukusetshenziswa kwe-Avandia kwehlile kakhulu ngemva kokukhishwa kwezixwayiso zokuqala.
Ngo-2010 i-FDA yayinqanda imishayezo emisha ye-Avandia kubantu abangeke bakwazi ukulawula i-glucose yegazi ngezinye izidakamizwa zesifo sikashukela noma abangakwazi ukuthatha i-Actos.
Ngo-2013, imiphumela ye-RECORD isilingo somtholampilo ayikho ingozi eyengeziwe yokuhlasela kwenhliziyo nge-Avandia (rosiglitazone). Ngenxa yalokho, ngo-2013 i-FDA yaphakamisa imingcele ebekiwe eyabekwa ku-Avandia. Ngomhla ka-16 Disemba 2015, i-FDA iqede uhlelo lokuHlola nokuHlelwa kweNgcono yokuthola imishanguzo ene-rosiglitazone, ephethe ukuthi izinzuzo zidlula izingozi.
Kodwa-ke, i-European Medicines Agency imise ukuthengiswa kwe-rosiglitazone ngo-2010 kanti ama-Agencies aseMFulentshi naseJalimane ama-Medicines agxilise ukusetshenziswa kwe-pioglitazone (i-Actos) ngo-2011.
Imiphumela emibi kanye nezingozi
Imiphumela emibi evamile ihlanganisa ukuzuza kwesisindo, izifo ezingaphezulu zokuphefumula, ukutheleleka kwesinus , ukuphathwa ikhanda kanye nokuphefumula kwesisu . Imiphumela emibi kakhulu ihlanganisa ukugcinwa kwamanzi, ukuhluleka kwenhliziyo, ukuzuza kwesisindo, nobuhlungu besisu. Ezinye imiphumela emibi ingase ihlanganise ikhanda, i-cholesterol ephezulu, amathambo abuthakathaka, izinkinga zamehlo nezinyosi.
Nakuba kungekho bufakazi obukhona obonisa ukuthi i-Actos noma i-Avandia ibangele izinkinga zesibindi, kuwukuhlakanipha ukugcina iso lezimpawu njenge-nausea, ukuhlanza, ubuhlungu besisu, ukukhathala, ukulahlekelwa ukudla, i-jaundice (ukuphuzila kwesikhumba namehlo), futhi umchamo omnyama.
Ubani Okungafanele Asebenzise Thiazolidinediones
Abantu abane-type 1 yesifo sikashukela (okudinga ukujova njalo kwe-insulin), ukwehluleka kwenhliziyo, noma isifo sobindi akufanele basebenzise i-thiazolidinediones. Izingane nabesifazane abakhulelwe noma abahlengikazi kufanele futhi bagweme ukusebenzisa le mithi. Abantu abanenkinga yamehlo noma yethambo kufanele bakhulume nabahlinzeki babo bezempilo ngaphambi kokuthatha i-thiazolidinediones.
Okunye ukusebenzisa "I-Off-Label"
I-Actos ingasiza ekwelapheni i-cholesterol ephezulu. I-Thiazolidinediones ingasiza futhi ukwandisa i-ovulation nokuzala ku-polycystic ovary syndrome.
Yini Okunye Okungazi Ngayo Nge-Thiazolidinediones
I-Thiazolidinediones kufanele ithathwe nsuku zonke.
Zingathatha izinyanga ezintathu ukuze zisebenze ngokugcwele. Uma umuntu ehlangabezana nanoma yimiphi imiphumela emibi, ikakhulukazi ukuvuvukala, ukuzuza ngokuzumayo, ukuphefumula kanzima, ukushaya inhliziyo, ukushintsha esikhathini, noma amathambo aphukile, azise umhlinzeki wezempilo ngokushesha.
Kodwa abantu abanesifo sikashukela, noma kunjalo, akufanele bayeke ukuthatha imithi yabo ngaphandle kokuba bafundiswe ukwenza kanjalo. Kubalulekile ukubona udokotela ukuze uthole ukunakekelwa okusondelene eduze ngenkathi uthatha i-thiazolidinediones. Lokhu kufaka phakathi ukuhlolwa kweshukela egazini, ukuhlolwa komsebenzi wesibindi, nokuhlolwa kweso.
Imithombo:
UMahaffey, uKenneth W .; Hafley, Gail; Dickerson, Sheila; Burns, Shana; U-Tourt-Uhlig, uSandra; Mhlophe, Jennifer; Newby, uL. Kristin; U-Komajda, uMichel; UMcMurray, uJohn; Bigelow, uRobert; Ikhaya, uFiliphu D .; Lopes, Renato D. (2013). "Imiphumela yokuhlaziywa kabusha kwemiphumela yenhliziyo ekulweni kwe-RECORD". I-American Heart Journal 166 (2): 240-249.e1.
Drazen, MD, Jeffrey M., uStephen Morrissey, Ph.D., noGregory D. Curfman, MD "Rosiglitazone-Ukuqhubeka Nokungaqiniseki Ngokuphepha." I-New England Journal of Medicine. 357 (2007): 63-64.
I-FDA Ukuphepha Kokuphepha Kwezidakamizwa: I-FDA idinga ukususwa kwemikhawulo ethile yokumisela nokuhambisa imithi yokwelapha i-rosiglitazone eline-diabetes. I-FDA Newsroom. 11/25/2013. Ukuphathwa kwe-US nokuDrug.
UDavid K. McCulloch, MD. "Thiazolidinediones ekwelapheni isifo sikashukela," Dec. 17, 2015. UpToDate.