Thiazolidinediones ke meriana ea molomo e thusang ho fokotsa tsoekere ea mali ka lefu la tsoekere la mofuta oa 2 . Ntle le ho ja lijo tse nepahetseng le ho ikoetlisa, ke tsela e 'ngoe ea ho thibela tsoekere ea mali. Li boetse li tsejoa e le glitazones.
US, thiazolidinediones e fumanehang joale e kenyelletsa Actos (pioglitazone), Avandia (rosiglitazone), le Avandamet (rosiglitazone le metformin) ea motsoako.
Li-restriction tsa mangolo a FDA li phahamisa lithibelo ka rosiglitizone ka 2013 ka mor'a ho phethahatsa bopaki bo bocha bo bontšang hore ha ho na kotsing ea ho hlaseloa ke pelo, empa lithibelo li ntse li le teng Europe.
Dos le Dont
Thiazolidinediones e thusa ho fokotsa insulin ho hanyetsa lisele, ho ntlafatsa tsela eo 'mele o arabelang ka eona ho insulin. Hangata li nkoa ka molomo hanngoe kapa habeli ka letsatsi. Ho phaella moo, li ka 'na tsa sebelisoa li le mong, ka lipilisi tse ling, kapa ka insulin. Thiazolidinediones ha e nke sebaka sa insulin 'meleng' me ha e susumelle 'mele ho etsa insulin e eketsehileng. Ha ba reretsoe ho nkela phepo e nepahetseng kalafo eo lingaka li e khothalletsang.
Histori ea Sebeliso
Ho tloha bofelong ba bo-1990, thiazolidinediones e 'nile ea sebelisoa ho tšoara lefu la tsoekere la mofuta oa 2. Moriana oa pele sehlopheng sena, Rezulin, o ile oa tlosoa marakeng oa US ka lebaka la mathata a sa tloaelehang empa a matla a sebete. Litlaleho tse ling li hlahisitse ho tšoenyeha ka kotsi e eketsehileng ea ho hlōleha ha pelo ho bakuli ba nkang Avandia.
Litlaleho tse ling li bontšitse kotsi e eketsehileng ea lefu la pelo le thiazolidinediones, le hoja khokahano ena e ntse e sa sireletsoa.
FDA e ile ea laela, ka 2006, hore meriana ea lithethefatsi bakeng sa Avandia e lemosa ka kotsi e eketsehileng ea tlhaselo ea pelo le bohloko ba sefuba ho bakuli ba bang. Tšebeliso ea Avandia e theohile haholo ka mor'a hore litemoso tsa pele li fanoe.
Ka 2010, FDA e thibela melaetsa e mecha ea Avandia ho batho feela ba neng ba sa khone ho laola tsoelo ea mali ea bona le meriana e meng ea lefu la tsoekere kapa ba sa khoneng ho nka Actos.
Ka 2013, liphello tsa teko ea meriana ea RECORD ha lia ka tsa eketseha kotsi ea lefu la pelo le Avandia (rosiglitazone). Ka lebaka leo, ka 2013 ba FDA ba phahamisa lithibelo tse behiloeng tse behiloeng ho Avandia. Ka la 16 December, 2015, FDA e ile ea felisa leano la ho hlahloba kotsi le ho fokotsa menyetla ea meriana e nang le li-rosiglitazone, ka ho etsa qeto ea hore melemo e phahametseng likotsi.
Leha ho le joalo, European Medicines Agency e emisitse ho rekisoa ha rosiglitazone ka 2010 mme mekhatlo ea Meriana ea Mafora le ea Jeremane e emisitse tšebeliso ea pioglitazone (Actos) ka 2011.
Litla-morao le Likotsi
Litla-morao tse tloaelehileng li akarelletsa ho fumana boima ba 'mele, tšoaetso e phahameng ea matšoao, mafu a sinus , hlooho ea hlooho le lefu la phokolo ea mali. Litla-morao tse tebileng li kenyeletsa ho boloka metsi, ho hloleha ha pelo, ho ba le boima ba 'mele le bohloko ba mesifa. Litla-morao tse ling li ka kenyelletsa hlooho ea kelello, k'holeseterole e phahameng, masapo a fokolang, mathata a mahlo le ma-hives.
Le ha ho na bopaki ba hona joale bo bontšang hore Actos kapa Avandia e bakoa ke mathata a sebete, ke bohlale ho hlokomoloha matšoao a joalo a kang ho nyekeloa ke pelo, ho hlatsa, bohloko ba mpa, mokhathala, ho lahleheloa ke takatso ea lijo, jaundice (mosehla oa letlalo le mahlo), le motsoako o lefifi.
Ke Mang ea sa Lokelang ho Sebelisa Thiazolidinediones
Batho ba nang le lefu la tsoekere la mofuta oa 1 (ba hlokang liente tsa kamehla tsa insulin), lefu la pelo, kapa lefu la sebete ha baa lokela ho sebelisa thiazolidinediones. Bana le basali ba moimana kapa ba anyesang ba lokela ho qoba ho sebelisa meriana ena. Batho ba nang le mathata a mahlo kapa a lesapo ba lokela ho bua le bafani ba bona ba bophelo pele ba nka thiazolidinediones.
Litlhapi tse ling tsa "Off-Label"
Actos e ka thusa ho phekola k'holeseterole e phahameng. Thiazolidinediones e ka boela ea thusa ho eketsa tlhahiso ea ho ruruha le ho ba le botenya ho polycystic ovary syndrome.
Seo U ka se Tsebang ka Thiazolidinediones
Thiazolidinediones e lokela ho nkoa letsatsi ka leng.
Ba ka 'na ba nka likhoeli tse tharo ho sebetsa ka botlalo. Haeba motho a e-ba le litla-morao, haholo-holo ho ruruha, ho ba le boima ba tšohanyetso, ho phefumoloha ho thata, ho otlolla pelo, ho fetoha ha mosali kapa ho robeha masapo, tsebisa mofani oa tlhokomelo ea bophelo hang-hang.
Leha ho le joalo, batho ba nang le lefu la tsoekere ha baa lokela ho khaotsa ho noa meriana ntle le ho laeloa hore ba etse joalo. Ke habohlokoa ho bona ngaka bakeng sa tlhokomelo e haufi ea ho latellana ha u ntse u nka thiazolidinediones. Sena se lokela ho kenyeletsa tlhahlobo ea tsoekere ea mali, liteko tsa sebete, le ho hlahlojoa ha mahlo.
Lisebelisoa:
Mahaffey, Kenneth W .; Hafley, Gail; Dickerson, Sheila; Burns, Shana; Tourt-Uhlig, Sandra; White, Jennifer; Newby, L. Kristin; Butjda, Michel; McMurray, John; Bigelow, Robert; Lehae, Philip D .; Lopes, Renato D. (2013). "Liphello tsa tlhahlobo e ts'oanelang ea liphello tsa pelo ho nyeoe ea RECORD". American Heart Journal 166 (2): 240-249.e1.
Drazen, MD, Jeffrey M., Stephen Morrissey, Ph.D., le Gregory D. Curfman, MD "Rosiglitazone-O ile a tsoela pele ho sa Tiisehe ka Tšireletseho." The New England Journal of Medicine. 357 (2007): 63-64.
Tlhaloso ea Tšireletso ea Lithethefatsi ea FDA: FDA e hloka hore ho tlosoe lithibelo tse itseng tsa ho fana ka meriana ea lefu la tsoekere ea rosiglitazone. FDA Newsroom. 11/25/2013. US Administration of Drug and Drug Administration.
David K. McCulloch, MD. "Thiazolidinediones ha ho phekoloa lefu la tsoekere," la 17, 2015. UpToDate.