Asidi Ursodeoxycholic: malangizo ntchito, analogs, ndemanga

Posachedwapa, zochizira zotupa zosiyanasiyana chiwindi ochuluka ntchito asidi ursodeoxycholic. Malangizo ntchito pawiri mankhwala zikusonyeza nchito zake matenda oopsa ambiri. Kodi zinthu izi? ursodeoxycholic asidi ndi chiyani? Mankhwala zimene alipo?

mafotokozedwe

asidi Ursodeoxycholic, ntchito ozikidwa pa chiyambi chake ndi katundu, ndi woyera-chikasu crystalline ufa. Iwo ali kulawa zowawa. mankhwala ali bwinobwino lizigwira la munthu amapangidwa zedi yaing'ono. yokoka yake yeniyeni ndi za 5% mwa kulemera kwa okwana zidulo ya ndulu. Ndi hydrophilic ndipo alibe cytotoxicity. Izi pawiri mankhwala ndi sungunuka mowa ndi asidi glacial acetic, pang'ono sungunuka mu chloroform ndi pafupifupi insoluble m'madzi. asidi Ursodeoxycholic si ali mankhwala. Anapeza mu ndulu ya bulauni chimbalangondo.

asidi Ursodeoxycholic (UDCA) ndi epimer asidi chenodeoxycholic. Poyamba icho chinali kugwiritsidwa ntchito zochizira Reflux gastritis ndi gallstones akuwaza. Patapita nthawi, anayamba kugwiritsidwa ntchito, ndi matenda ena ambiri. UDKH ankaona otetezeka kwambiri zidulo ya ndulu.

Mmene asidi ursodeoxycholic

Pakali pano, ntchito UDKH ndi muyezo amalimbikitsa cholestatic matenda osiyanasiyana chiwindi ndi chigawo autoimmune. Limagwirira cha zochita za wothandizila izi ziziyenda maselo a thupi. mamolekyulu yake inalowa mu nembanemba maselo chiwindi - hepatocytes. Chifukwa cha ichi iwo amatha kupanga iwo zambiri kugonjetsedwa ndi zinthu zikuwononga. Izi wothandizila hepatoprotective kumakhudza choleretic. UDKH kuchepetsa mafuta m'thupi kaphatikizidwe mu chiwindi ndiponso kupewa mayamwidwe ake mu intestine lapansi. Izi mankhwala Sachita ndi kukwezedwa lithogenicity zili ya ndulu asidi mmenemo. Imeneyi timapitiriza ntchito za lipase, pancreatic ndi katulutsidwe muzituluka. asidi Ursodeoxycholic kumakhudza hypoglycemic ndipo zimachititsa mapangidwe ndi kulekana kwa ya ndulu, amachepetsa mafuta.

Izi mankhwala amakonda tsankho kapena wathunthu pogawanikana pamawere miyala mafuta. N'chifukwa chake ntchito nthawi zambiri. Kulumikiza ndi mafuta, izo kumawonjezera solubility timibulu ake, amene amachita deleteriously pa gallstones. UDKH ali immunomodulating kanthu amene ali kuonjezera lymphocyte ntchito, amachepetsa mawu a antigens osiyana pa nembanemba wa hepatocytes. Zingamvekere chiwerengero cha T-lymphocytes, amachepetsa chiwerengero cha eosinophils.

UDKH amachepetsa ndende ya mafuta mu ya ndulu ndi kupezeka kwake, ndi kusintha zinthu mu gawo madzi galasi. Iwo zimakhudza enterohepatic makope salt ya ndulu. Chifukwa cha ichi utachepa reabsorption mu m'matumbo mankhwala amkati hydrophobic ndi poizoni. Izi mankhwala ali hepatoprotective mwachindunji ndi zotsatira choleretic. asidi Ursodeoxycholic, amene amakambirana za akatswiri mu hepatology kusonyeza nchito zake, angathe kuchepetsa chiwindi fibrosis mu mafuta alibe ake.

ntchito

asidi Ursodeoxycholic, amene ntchito imagwiridwa kuyang'aniridwa ndi dokotala kupezeka akapatsidwa pa zinthu zimenezi pathological:

• pamaso pa miyala mafuta isanafalikire mu ndulu kapena wamba ritsa;

• Kulephela kuchitira endoscopically kapena opaleshoni;

• aakulu, atypical, ndi pachimake autoimmune chiwindi ;

• pamaso pa miyala mafuta pambuyo makina ndi extracorporeal lithotripsy;

• poizoni (mankhwala, mowa), kuwonongeka chiwindi;

• matenda cholangitis;

• chachikulu biliary matenda enaake, ndi zizindikiro za decompensation;

• atresia thirakiti biliary;

• enaake fibrosis;

• aakulu yogwira chiwindi;

• cholestasis pa zakudya parenteral;

• biliary dyskinesia;

• biliary dyspeptic syndrome ndi dyskinesia biliary ndi holetsistopatii;

• opistorhoze aakulu;

• kobadwa nako biliary atresia;

• biliary Reflux esophagitis ndi Reflux gastritis.

asidi Ursodeoxycholic (UDKH) ntchito popewa kuwonongeka chiwindi anachititsa ndi utsogoleli wa cytostatics ndi kulera m'thupi. Izo analamula kuti matenda ena oyambitsidwa ndi stagnation wa ya ndulu. UDKH tapatsidwa mankhwala adjuvant mu chiwindi kupatsidwa zina kapena chiwalo ena.

contraindications

asidi Ursodeoxycholic, omwe amakambirana ndi mbali zabwino, ali contraindications kwambiri. Njirazi ndi monga:

• Matenda yotupa kwa chikhodzodzo ndulu, matumbo ndi ya ndulu ducts mu gawo pachimake;

• rentgenopolozhitelnye gallstones ndi okhutira mkulu kashiamu;

• kutsekeka kwa mundawo biliary;

• hypersensitivity;

• matenda enaake pa decompensation;

• matenda amene amatupitsa;

• kutchulidwa monyanyira mu ntchito kwa kapamba, chiwindi ndi impso.

Pochita ntchito

asidi Ursodeoxycholic, malangizo ntchito zomwe momveka bwino pakalibe zofooka okhwima mu ntchito yake, si anatumizidwa ana kwa zaka 3 mawonekedwe kapisozi. Ntchito zawo pochiza slurry kupanga izi mankhwala mankhwala. Kufikira tsopano, akatswiri sizinachitike maphunziro yoyenera umalimbana kudziwa zotsatira za izi cholelitolitic mankhwala malingana ndi zaka mwanayo. Pa nthawi yomweyo, maphunziro imachitika pamaso pa ana ndi atresia biliary ndi matenda ena chiwindi sanasonyeze mavuto enieni Dokotala.

Kukonzekera munali asidi ursodeoxycholic, kuperekedwa kwa amayi oyembekezera okha pamene zotsatira anafuna mankhwala ndi wothandizila ichi ndi wamkulu kuposa chiopsezo lingathe mwana osabadwa. Tisaiwale kuti kuphunzira zonse za sayansi chitetezo mankhwala kwa gulu la odwala ndi aliyense anathera. Kuyambira Sizikudziwika ngati UDKH likulowerera mu mkaka wa m'mawere, tiyenera kusamala poika mankhwala kwa akazi unamwino.

zotsatira zoyipazi

asidi Ursodeoxycholic, malangizo ntchito zimene zikusonyeza osati zofooka mu ntchito kwake, komanso kuti chingachitike mbali, kungachititse kuti zochitika pathological monga:

• kudzimbidwa, m'mimba;

• nseru;

• kuchuluka transaminases;

• kupweteka kwa nusu pomwe chapamwamba ndipo epigastric dera;

• thupi lawo siligwirizana khungu (kuyabwa zidzolo);

• calcining miyala.

Chithandizo cha biliary matenda enaake yaikulu yokonza izi nthawi zina amayambitsa kuti wodwalayo ali decompensation zosakhalitsa anazimiririka pambuyo achire kulandira mankhwala.

kusamala

Bwinobwino litholysis mafuta miyala ntchito UDKH ayenera kuganizira zinthu izi:

• kukula si kuposa 2 cm;

• iwo alibe mthunzi pa radiograph ya;

• ndulu likugwira bwino;

• ducts kukhala patency;

• kuwira wodzazidwa ndi miyala zosakwana hafu;

• wamba ya ndulu ritsa lilibe miyala.

zoletsa zina ziti pa chikuonetseratu asidi ursodeoxycholic ndi? Malangizo kwa kukonzekera izi mankhwala limasonyeza kuti nthawi yaitali mankhwala, ndiwo mwezi oposa 1, ayenera nthawi zonse (1 aliyense masiku 30) kuchititsa kuwunika transaminases kwa chiwindi, phosphatase, bilirubin, Popanga madzi a gamma-glutamyl transferase magazi. Kuchititsa nkhani zoterozo kwambiri makamaka koyamba miyezi 3 mankhwala ndi UDKH. Mphamvu ya mankhwala zikutsimikiziridwa ndi X-ray miyezi sikisi iliyonse ndi ultrasound ya ndulu. Pakuti kupewa zisadzachitikenso a khunyu kupitiriza cholelithiasis chithandizo ndipo pambuyo kuvunda wathunthu wa miyala. Zimatenga miyezi yambiri.

Pa mankhwala UDKH akazi a msinkhu wobereka akulimbikitsidwa kugwiritsa ntchito njira yodalirika chitetezo mimba. Kungakhale mankhwala si m'thupi kapena kulera munali wochepa timafunika.

mawonekedwe kumasulidwa ndi mlingo

asidi Ursodeoxycholic, ndi limene malangizo Buku amapereka nkhani ya phwando circuitry ake, ndi kupanga mitundu ina mlingo:

• makapisozi ndi mapiritsi a 150 ndi 250 mg;

• kuyimitsidwa ana.

Mlingo UDCA mosamalitsa anapereka payekha. Izo zimatengera kukula kwa moyo wa munthu ndi thupi lake. Nthawi zambiri, izo zotchulidwa 10-20 mg / kg pa patsiku. mankhwalawa akutengedwa pa nthawi imodzi, madzulo. Kutalika kwa mankhwala zimadalira umboni. Izi mankhwala odzipereka mu intestine kakang'ono, ndipo pambuyo maola 3 plasma umadziwika ndende wake wapamwamba. Zonse phwando medicaments munali asidi ursodeoxycholic, kuusandutsa yaikulu ya ndulu asidi mu thupi la munthu. Nkhanizi chinaperekedwa zosiyanasiyana kusinthika ndi zotsatira zake zomalizira linanena bungwe monga metabolites mu ndowe ndi mkodzo.

Nthawi mankhwala anatsimikiza ndi dokotala nawo. Zimakhala osiyanasiyana malingana ndi mtundu wa matenda. Nthawi zina kwambiri, phwando UDKH mankhwala kumatenga zaka zambiri.

Mogwirizana ndi mankhwala ena

Mu phwando olowa ndi UDKH "Cyclosporine" sizimadziwika ukuwonjezeka mayamwidwe ya masika. Mu madzi a kwambiri kumawonjezera ndende za kukonzekera mankhwala. Nthawi zina za UDKH phwando imodzi ndi lokonzekera "Ciprofloxacin" ndende otsiriza amachepetsa.

asidi Ursodeoxycholic (analogues)

asidi Ursodeoxycholic (makapisozi, mapiritsi) chopangidwa pogwiritsa ntchito mayina osiyanasiyana. wothandizila amenewa amasiyana excipients adalowa zikuchokera awo. Choncho, msika akhoza kukumana mankhwala awa ndi asidi ursodeoxycholic:

• makapisozi "Ursosan" analamula kuti mankhwala matenda akakufunsani chiwindi, cholelithiasis, ndi biliary Reflux gastritis ndi Reflux esophagitis, matenda enaake chachikulu, mankhwala ndi poizoni kuwonongeka chiwindi, cholecystectomy, matenda mowa, matenda cholangitis, Biliary atresia, nonalcoholic steatohepatitis. asidi Ursodeoxycholic ( "Ursosan") ntchito kupewa zotupa chiwindi.

• Mapale "Ukrliv" amene mu kuwonongeka kwa chiwindi, kutupa aakulu, cholelithiasis.

• makapisozi "Ursofalk" asankha kuti zosiyanasiyana matenda a ndulu ndi chiwindi, limodzi ndi cholestasis, kuchepa kwa ena ntchito chiwindi, okwera mafuta misinkhu. Zikuphatikizapo chachikulu biliary matenda enaake ndi matenda cholangitis, Reflux gastritis ndi Reflux esophagitis, chiwindi a etiology osiyana, miyala mafuta m'thupi, enaake fibrosis, zotupa angapo a chiwindi, ya ndulu stasis. kukonzekera amagwiritsidwa ntchito ngati prophylactic ndi choipa chiwindi pamene kulandira mankhwala amphamvu.

• Mapale "Ursodeks" amene ali ndi matenda enaake biliary popanda zizindikiro decompensation ndi Reflux gastritis. Iwo ntchito kupasuka mafuta miyala ing'onoing'ono pa chamoyo zachilendo kwa chikhodzodzo ndulu.

• makapisozi "Ursodez" ntchito kuphwanyaphwanya mafuta miyala, mankhwala a Reflux gastritis, kwa mankhwala symptomatic kwa matenda enaake yoyamba ya chiwindi ndi zizindikiro za decompensation.

• makapisozi "Ursolizin" asankha kuti Kutha mafuta miyala, mankhwala symptomatic matenda enaake biliary, ndulu cholesterosis ndi Reflux gastritis. mankhwala ntchito mankhwala zovuta odwala matenda a chiwindi aakulu ndi matenda enaake.

• makapisozi "Choludexan" ntchito zochizira wopepuka cholelithiasis, aakulu yogwira chiwindi, zotupa mowa ndi poizoni chiwindi, nonalcoholic steatohepatitis, chachikulu biliary matenda enaake, chachikulu ndi matenda cholangitis, enaake fibrosis, biliary dyskinesia, Reflux gastritis ndi Reflux esophagitis.

• makapisozi "Urdoksa" zimene zinafotokozedwa biliary matenda enaake chachikulu, ndi zizindikiro za decompensation, Reflux gastritis. Mankhwala anali bwino amasungunula ang'ono ndi sing'anga mafuta miyala, pokhalabe ntchito zachilendo kwa chikhodzodzo ndulu.

• makapisozi "cholozera C", anapatsidwa pa wopepuka cholelithiasis, matenda enaake chachikulu, pachimake ndi chiwindi aakulu, matenda cholangitis, atresia thirakiti intrahepatic, Reflux gastritis ndi Reflux esophagitis, cholestasis, pa zakudya parenteral, biliary dyskinesia, chiwindi matenda, ndi enaake fibrosis, mafuta gepatoze, dyspeptic syndromes. lokonzekera ntchito popewa kuwonongeka chiwindi mu ntchito za kulera m'thupi ndi cytostatics, mwala lomenyera kunenepa.

asidi Ursodeoxycholic, analogs wa nkhaniyi atengedwa okha zotchulidwa dokotala.