Kunyange zvazvo mishonga yakawanda yakwegura yekurasikirwa kwemazivi (iyo yakange iri pamusika kwekanguva yemakore gumi, uye avo vakadzingwa kubva mumusika) vakaziva zvakakomba migumisiro, hazvina kuitwa kusvikira muna 2016 kuti mimwe midzi yemwoyo inokonzera iyo itsva yekurasikirwa kurasikirwa mishonga yakabvumwa, yakarongedzwa, uye inopfupikiswa nevanodzidza mwoyo.
Mishonga inopesana nekuwedzerwa kwehupeso yakagamuchirwa neU.S. Food and Drug Administration (FDA) kubvira muna 2010 yave ichifarira uye hurukuro inoramba ichikakavadzana munharaunda yehupenyu. Kuwedzera muviri kunowanzozivikanwa pangozi yehutano hwemwoyo, uye mararamiro ekuchinja mararamire ave kwenguva refu ari iyo yepamusoro sekutanga kwerapi.
Zvisinei, kune vanhu vane maitiro ekuchinja mararamiro havakwanisi kukurudzira huwandu hunokwana hutachiona hunoita kuti huve nehutano hwakanaka, kana kune avo vasina kukwanisa kushandisa zvinoraramisa mararamiro ehupenyu soutano hwakanaka uye maitiro ezvokudya , mishonga inopesana nekuneta kunogona kunge basa. Iyi mishonga inogona kuuya nematambudziko emwoyo, zvisinei, uye kusvikira Dr. Vorsanger nevamwe vashandi vakabudisa kuongorora nekupfupisa kwemigumisiro yemigumisiro yevashumiri mumusangano waAugust 2016 we Journal of the American College of Cardiology , izvi zvinokonzerwa nemwoyo yepfungwa hazvina rakatsanangurwa zvakanaka.
Migumisiro yeSaxenda (liraglutide)
Saxenda (liraglutide) yakagamuchirwa neDFA musi waDecember 23, 2014, senzira yekurapa kwekusagadzikana kwekutakura. MuUnited States, Saxenda inoshambadzirwa naNovo Nordisk, Inc. Ichi chinodhaka ndechechikwata chikuru chezvinodhaka, chinonzi biochemically se glucagon-se peptide-1 (GLP-1) receptor agonists, yakatanga kuiswa kumusika wekurapa rudzi 2 chirwere cheshuga.
Shanduro ye Saxenda (liraglutide) iyo inoshandiswa pakurapa chirwere cheshuga ndeyeicho chidimbu chinonzi liraglutide chinotengeswa pasi pezita rinonzi Victoza. Victoza / Saxenda inowedzera kunzwisiswa kwemasero ari pancreas kusvika paglucose, zvichiita kuti pancreas ishande zvakanyanya mukubatsira kubvisa glucose (shuga) kubva muropa.
Saxenda inokonzera kuora muviri kuburikidza nekuita pakati pepakati pemakwara muuropi kukurudzira kufara, zvichiita kuti vanhu vanzwe nekukurumidza zvakakwana. Izvi zvinogona kuderedza chido uye zvinotungamirira kudya zvishomanana, izvo zvinoguma nekukura kwekukura.
Asi zvii zvinoitwa naSaxenda pamwoyo? Mumakiriniki ekuedzwa, Saxenda yakawanikwa ichikonzera donho duku mu systolic ropa (nhamba yepamusoro) inosvika 2.8 mamita emamiriyoni. Zvisinei, kurapwa naSaintenda kwakaratidzwawo kuti inobatanidza nekuwedzera kwemaitiro emwoyo ye 3 kurova paminiti. Kurasikirwa nekurasikirwa kwemishonga yakawedzera kuwedzera kwemwoyo kwakaguma kuwanikwa kunobatanidza nematambudziko makuru emwoyo, saka iyi inzvimbo yekufungisisa uye nzvimbo inokosha kuti uone kutsvakurudza kwakawedzerwa.
Izvo zvinofanira kuonekwa kuti, ikozvino, keriniki miedzo yakadai seS SCALE Maintenance trial, yakashumwa muIndaneti Journal of Obesity neWadden uye vashandi pamwe chete muna 2013, vakawana zviitiko zvakakomba zvepfungwa (sekurwadziwa kwemwoyo uye kufa kwemwoyo) kuti zvive zvishoma naVa Victoza / Saxenda; Zvechokwadi, zviitiko zvakakomba zvakadai zvakaderera muboka reVictoza / Saxenda kupfuura pane boka re placebo (avo vasingatori Victoza / Saxenda).
Muchirongwa cheSALALE Maintenance pachake, kwaingova norufu rimwe chete rwakafanira kukanganisa kwemwoyo, uye kuti rufu rwakaitika muboka re placebo; vatori vechidzidzo vakanga vari kutora Victoza / Saxenda vakanga vasina zviitiko zvakakomba zvemwoyo zvachose.
Zvichida zvinonakidza zvikuru, mumutambo we LEADER, mitsara yemwoyo yakataurwa kune imwe nzvimbo muIndaneti England Journal of Medicine munaJune 2016, vanenge vanokwana 9 300 vane chirwere cheshuga vakanga vari pangozi yehutano hwepfungwa vakaongororwa, uye shure kwemakore mashanu, avo avo vakanga vari kutora Victoza vaiva nehuwandu hwehutano hwekufa nekuda kwehutano hwehutano, pamwe chete nehuwandu hwehutano hwepfungwa uye chirwere.
Kubva pamigumisiro yakadai, nyanzvi dzakawanda dzinofungisisa zvakanyanyisa mikana iyo Victoza inogona kubatsira kudzivirira chirwere chemwoyo kune varwere vane chirwere cheshuga. Zvisinei, zvakakosha kuziva kuti izvi zvinogumira hazvikwanisi kubudiswa kune varwere vasina chirwere cheshuga avo vari kutora Saxenda chete nokuda kwekurasika. Zvidzidzo zvaidiwa kuti zviongorore zvakadaro mitsara yemweya ye Saxenda pa 3-milligram dose inoshandiswa mukurapa kwekuneta kunenge isati yaitwa.
Migumisiro Yokupikisa (naltrexone / bupropion)
Kusiyanisa (naltrexone / bupropion) kwakagamuchirwa neDFA musi waSeptember 10, 2014, pakurapa kuneta. Inotengeswa naOrexigen Therapeutics, Inc., uye ine mishonga miviri mukati mepiritsi imwe: naltrexone uye bupropion.
Naltrexone, yakashandiswa iga, yakatanga kugamuchirwa neRDA sechirwere chekudhakwa kweopioid uye kudhakwa kwewaini. Bupropion, yakashandiswa yoga, yakagamuchirwa uye inoshandiswa pakurapwa kwekuora mwoyo, nguva yechirwere chepfungwa (SAD), uye kusvuta kusvuta.
Vose pamwe chete muwedzere-kusunungurwa tablet ye Contrave, zvisinei, iyo mishonga miviri inobatanidza kukonzera kuora.
Zvose izvi mishonga yakave yakambowanikwa ine migumisiro inosanganisira moyo nemoyo. Kunyanya, migumisiro yekupikisa pamwoyo yehutachiona uye kuwedzerwa kweropa kunoratidzika kusina kunaka. Mumakiriniki, miviri yakawanikwa ichiwedzera kuwedzera kweropa uye kushaya mwoyo.
Kune rumwe rutivi, zvinokonzerwa nekupikisa purogiramu yecholesterol zvakaratidzwa kunge zviri nani, uye kuwedzerwa kunoonekwa muHDL cholesterol (inowanzonzi "yakanaka" cholesterol) uye inoderera muviri LDL cholesterol ("yakaipa" cholesterol) uye Triglycerides (mafuta acids muropa).
Migumisiro yeCsymia (phentermine / topiramate)
Qsymia (phentermine / topiramate) yakagamuchirwa neCDA muna 2012 uye inotengeswa neVIVUS. Kufanana nekupindirana, inewo mishonga miviri mukati mepiritsi imwe: phentermine uye topiramate.
Phentermine pachayo inogona kukanganisa kudya uye kuwedzera masimba emari ekushandisa, izvo zvinoita kuti kuora kurasike. Zvechokwadi, phentermine haisi mushonga mutsva nekuda kwechinangwa ichi, sezvachakabvumirwa muna 1959 neDFA nokuda kwekurapwa kwenguva pfupi yekuwedzerwa. Iyo yakagara ichingorambidzwa nedzimwe migumisiro, zvisinei, yakapiwa kuti iyo nzira yekuita inosanganisira kuwedzera norepinephrine (adrenaline) mazinga mumuviri.
Topiramate, kune rumwe rutivi, ine nzira isinganzwisisiki yekugadzirisa kurasikirwa, uye nenzira dzakasiyana-siyana dziri kuiswa, kusanganisira kuderedza zvakasiyana mukudya uye adipose (mafuta) tissue. Topiramate chete, inoshandiswa pamusana wepamusoro kupfuura chiremba inowanikwa muQsymia, inogona kukonzera kuora kwe 2.2 muzana kune 5.3 muzana yekutanga kuyerwa kwemuviri.
Qsymia inobatanidza zvose phentermine uye topiramate mune imwe piritsi uye pamadhora maduku kupfuura zvinodhaka zvinoshandiswa chete. Qsymia yakaedzwa mumakirini mana emakiriniki, uye pakupedzisira, nemhaka yemigumisiro yechipfupa yaro, FDA yakaraira kuti ruzivo ruonekwe pairira yake inotaura kuti kushandiswa kwayo hakukurudzirwi kune varwere vane chirwere chepfungwa chazvino kana chisingachinji.
Mikana yemigumisiro yomuviri iyo yakange iine hanya nemishonga iyi yakasanganiswa inosanganisira yakakwirira yemitambo, nechinhu chinonyanya kukonzera kukura kwe tachycardia (nokukurumidza mwoyo rhythm) kune vamwe varwere.
Nei Kune Chido Chokurwisa Kuwedzerwa Kwemishonga?
NeAmerican Medical Association (AMA) inoratidzira zvakadzama kufutisa sechirwere muna 2013, chikamu chetatu (35 muzana) vevanhu vakuru vekuAmerica vakava vatakuri vezvirwere zvisingagumi zvekubatanidzwa nehuwandu hwehutano hwehutano hwehutano.
Kunyange zvazvo mararamiro ehutano achichinja, kuburikidza nehutano hwakanaka hwekudya uye humwe hutano hwekuita, huchiri iyo nzira yakarongwa yekutanga yekurasikirwa, vanhu vazhinji vane hutano hwakanyanya vakawana zvakaoma, nekuda kwezvikonzero zvakasiyana, kuti vawane kukwana kurasikirwa kwakakwana kuburikidza nehupenyu hwekuchinja huga. Pinda mishonga inopesana nekuwedzerwa kwehuputa, iyo inotarisa kudiwa kwezvimwe zvezvechirongwa zvingashandiswa pakurapa kuneta.
Chii Chaunofanira Kuita Kana Uri Kutora Chimwe Chezvinhu Zvinodhaka?
Nguva dzose kurukura nechiremba wako chero zvingava nemigumisiro yemishonga mutsva, uye iva nechokwadi chokuti chiremba wako anoziva nhoroondo yako yezvokurapa-kunyanya kana iwe uine nhoroondo yehutano hwehutano, kusanganisira kukwirira kweropa, chirwere chemwoyo, kana chirwere.
Kana iwe uri kutora imwe yemishonga inotevera uye iwe unosangana nemimwe yemigumisiro yemoyo yakarongwa, kana iwe ukatanga kutarisana nemigumisiro yakaipa iyo isina kunyorwa asi iwe unofunga kuti ingave yakakonzerwa nemishonga yako, iva nechokwadi chekuita izvi kuti ucherechedze wechiremba wako wezvechiremba pakarepo.
Chengetedza ropa rako uye kushaya mwoyo (kupisa) paunenge uchitora mishonga iyi, uye rega chiremba wako azive kana iwe uchicherechedza chero kuchinja kunokosha.
Uyewo, zvinokosha, ramba uchitarisa uremu hwako. Nzira yakanakisisa yekuita izvi ndeyokuzviyera panguva imwe chete zuva nezuva. Kana iwe usiri kuona kuora kwekurasikirwa paunenge uchitora imwe yemishonga iyi, zvino mishonga inogona kunge isina kukushandira iwe, kana zvimwe zvingave zviri kutamba. Chero zviitiko zvose, taura nachiremba wako kuitira kuti iwe ugone kuona kana kuti kwete kuramba uchibata mishonga.
Sources:
Marso SP, Poulter NR, Nissen SE, et al. MUTADZIDZI Mutsvaga kuongorora. Liraglutide uye nemigumisiro yemwoyo mumhando yechirwere cheshuga. N Engl J Med . 2016 Jun 13 [E-pub mberi kwekunyora]
Secher A, Jelsing J, Baquero AF, et al. Nucleus inoputika inopindirana GLP-1 receptor agonist-liraglutide-inoderedza kurasikirwa kwemazi. J Clin Invest . 2014; 124: 4473-4488.
Vorsanger MH, Subramanyam P, Weintraub HS, et al. Mwoyo yemigumisiro yeiyo nhengo yekurasikirwa maitiro. J Am Coll Cardiol . 2016; 68: 849-859.
Wadden TA, Hollander P, Klein S, et al. Kurema kwehutano nekuwedzera kuora kurasikirwa ne liraglutide mushure me-low-calorie-kudya-induced kuora kurasikirwa: SCALE Maintenance randomized study. Int J Obes (Lond). 2013; 373: 11-22.