Thiazolidinediones waa daawooyin afka ah oo kaa caawin kara sonkorta dhiigga ee nooca 2aad ee sonkorowga . Marka lagu daro cunto caafimaad leh iyo jimicsi, waxay yihiin hab kale oo lagu xakameyn karo heerka sonkorta dhiigga. Waxa kale oo loo yaqaan glitazones.
Dalka Mareykanka, thiazolidinediones waxaa hadda laga heli karaa Actos (pioglitazone), Avandia (rosiglitazone), iyo daroogada loo yaqaan 'Avandamet' (rosiglitazone iyo metformin).
FDA waxay xayirtay xayiraadaha daawada rosiglitizen ee sanadka 2013 ka dib markii lagu soo gabagabeeyay caddayn cusub oo muujinaysa khatar sare oo ka iman karta wadnaha, laakiin mamnuucistu waxay ku jirtaa Yurub.
Dos iyo Dont's
Thiazolidinediones waxay kaa caawineysaa in aad hoos u dhigto iska-caabinta insulin ee unugyada, hagaajinta habka uu jidhku uga jawaabayo insulinta. Waxaa caadi ahaan la qaataa afka mar ama laba jeer maalin kasta. Waxaa intaa dheer, waxaa loo isticmaali karaa kali ahaan, kiniinno kale, ama insulin. Thiazolidinediones ma beddelaan insulin-ta jidhka mana u sameeyaan jirka si loo abuuro insulin dheeraad ah. Looma jeedo inay beddelaan cunto caafimaad leh dhakhtar ayaa kugula talinaya mid kale.
Taariikhda isticmaalka
Taniyo dabayaaqadii 1990-yadii, thiazolidinediones ayaa loo isticmaalay in lagu daaweeyo nooca 2aad ee sonkorowga. Daroogada koowaad ee fasalkan, Rezulin, ayaa laga saaray suuqyada Maraykanka sababtoo ah dhibaatooyinka beerka ee aadka u daran laakiin halis ah. Warbixinnada qaar ayaa kordhiyay walaac ku saabsan khatarta sii kordheysa ee wadnaha ee bukaanka ee Avandia.
Warbixinno kale ayaa soo jeediyay in khatarta kordhaysa ee wadno-qabka wadnaha la leh thiazolidinediones, inkastoo xiriirkani aanu wali la helin.
FDA ayaa amar ku bixisay, 2006-dii, soosaaridda daroogada ee Avandia ka digtay khatarta sii kordheysa ee wadno-qabadka iyo xanuunka feedhaha ee bukaannada qaarkood. Isticmaalka Avandia ayaa hoos u dhacay ka dib markii digniinihii ugu horreeyay la soo saaray.
Sannadkii 2010 FDA waxay xadidey daawooyinka cusub ee Avandia kaliya dadka aan awoodin inay xakameeyaan gulukooskooda dhiigooda iyagoo isticmaalaya dawooyinka kale ee sonkorowga ama kuwa aan awoodin inay qaataan Actos.
Sannadkii 2013, natiijooyinka tijaabada caafimaad ee RECORD wax khatar ah kuma aysan kordhin wadno xanuunka Avandia (rosiglitazone). Natiijo ahaan, 2013-kii FDA waxay kor u qaaday xayiraadaha qoritaanka ah ee lagu dhigay Avandia. Diseembar 16, 2015, FDA waxay tirtirtay Istaraatiijiyada Khatarta ah iyo Istaraatijiyeynta Miisaanka ee loogu talagalay daawooyinka rosiglitazone-ku jira, iyadoo lagu soo gabagabeynayo in faa'idooyinka ka culus halista.
Si kastaba ha ahaatee, Hay'adda Caafimaadka ee Yurub ayaa joojisay iibinta rosiglitazone sanadka 2010 iyo hay'adaha Dawooyinka Faransiiska iyo Jarmalka ayaa sidoo kale hakiyey isticmaalka isticmaalka pioglitazone (Actos) sanadkii 2011.
Saameynada iyo Dhibaatooyinka
Dhibaatooyinka caadiga ah waxaa ka mid ah miisaan kordha, infakshanka neefta ee sare, infekshanka sanka , madax-xanuun, iyo dhiig-yaraan. Dhibaatooyinka halista ah waxaa ka mid ah hannaanka dareeraha, wadnaha oo shaqeyn waaya, miisaanka oo kordha, iyo muruq xanuun. Waxyeellooyinka kale ee kale waxaa ka mid noqon kara madax-xanuun, kolestarool, lafaha daciifka ah, dhibaatooyinka indhaha iyo cuncunka.
Inkasta oo aysan jirin caddaynta hadda jirta ee muujinaysa in Actos ama Avandia ay sababi karto dhibaatooyinka beerka, waxaa habboon in la isha lagu hayo astaamaha sida lallabbo, matag, xanuun caloosha, daal, cunto xumo, cagaarsho (maqaarka iyo maqaarka), iyo Kaadi madow.
Yaa Yaa Isticmaalin Thiazolidinediones
Dadka qaba sonkorowga nooca 1 (waxay u baahan yihiin insulin joogto ah), wadnaha wadnaha, ama cudur beerka waa in aysan isticmaalin thiazolidinediones. Carruurta iyo haweenka uurka leh ama dumarka kalkaaliyaasha ah waa inay sidoo kale iska ilaaliyaan isticmaalka daawooyinkan. Dadka qaba dhibaatooyinka indhaha ama lafaha waa inay kala hadlaan bixiyeyaashooda caafimaadka ka hor inta aysan qaadan thiazolidinediones.
Waxyaabaha kale "Off-Label" waxay isticmaalaan
Actos wuxuu ka caawin karaa daaweynta kolestaroolka sare. Thiazolidinediones ayaa sidoo kale laga yaabaa in ay gacan ka geysato kor u qaadista ugxanta iyo bacriminta ku jirta syndrom systolic syndrome.
Waxyaabaha kale ee la ogaanayo Thiazolidinediones
Thiazolidinediones waa in la qaataa maalin kasta.
Waxay qaadan karaan ilaa saddex bilood si ay u yeeshaan saameyn buuxda. Haddii uu qofku dareemo waxyeellooyin soo raaca, gaar ahaan barar, miisaan kedis ah, neefta oo adkaata, wadne garaaca, isbeddel caadada ama lafaha jabay, isla markiiba u sheeg dhakhtar daryeel caafimaad.
Hase yeeshee, dadka qaba sokorowga, waa inaysan joojin qaadashada dawadooda, haddii aan sidaas lagu sheegin. Waa muhiim in la arko dhakhtar si loo ilaaliyo daryeelka dabagalka markaad qaadato thiazolidin. Tani waa inay ku jirtaa baaritaanka sonkorta dhiigga, baaritaanka shaqada beerka, iyo baaritaanka indhaha.
Ilaha:
Mahaffey, Kenneth W .; Hafley, Gail; Dickerson, Sheila; Gubasho, Shana; Tourt-Uhlig, Sandra; White, Jennifer; Newby, L. Kristin; Komajda, Michel; McMurray, John; Weyn, Robert; Home, Philip D .; Lopes, Renato D. (2013). "Natiijooyinka dib-u-qiimeynta natiijooyinka wadnaha iyo dhimirka ee tijaabada RECORD". American Heart Journal 166 (2): 240-249.e1.
Drazen, MD, Jeffrey M., Stephen Morrissey, Ph.D., iyo Gregory D. Curfman, MD "Rosiglitazone-Continued Uncertain on Safety." Wargeyska New England Journal of Medicine. 357 (2007): 63-64.
FDA Ammaanka Daroogada Isticmaalka: FDA waxay u baahan tahay in laga saaro qaar ka mid ah xayiraadaha iyo xaddidaadda daawooyinka rosiglitazone-ka kooban ee daawooyinka macaanka. Xafiiska FDA. 11/25/2013. Maamulka Cuntada iyo Dawooyinka Mareykanka.
David K. McCulloch, MD. "Thiazolidindiones ee daaweynta sonkorowga mellitus," Dec. 17, 2015. UpToDate.