Januvia ndi Janumet > Chithandizo ndi kupewa

Mankhwala 2 a shuga a Januvia ndi Janumet: pezani chilichonse chomwe mukufuna. Pansipa mupeza malangizo ogwiritsira ntchito olembedwa mchilankhulo. Unikani zomwe zikuwonetsa, contraindication, Mlingo, momwe mungatengere ndi zovuta zina. Amanenedwa za njira zabwino zamankhwala zomwe zimakupatsani mwayi wokhala ndi shuga 3.9-5,5 mmol / l khola maola 24 patsiku, monga mwa anthu athanzi. Dongosolo la Dr. Bernstein, yemwe akhala ndi matenda ashuga kwa zaka zopitilira 70, amakulolani kuti 100% mudziteteze ku zovuta. Mwatsatanetsatane, onani njira yothandizira odwala matenda ashuga amtundu 2.

Januvia ndi mankhwala a matenda a shuga a 2, chinthu chomwe ndi sitagliptin. Wopanga ndi kampani yotchuka yapadziko lonse Merck (Netherlands). Yanumet ndi mankhwala osakanikirana omwe amakhala ndi sitagliptin ndi metformin. Pansipa tikuyerekeza mwatsatanetsatane mapiritsi a Januvia ndi Galvus, komanso Yanumet ndi Galvus Met. Yankho lenileni limaperekedwa ku funso loti ndi iti mwa mankhwalawa omwe ndi abwino. The analogues yomwe imapangidwa ndi makampani opikisana azamankhwala amalembedwa.

Januvia ndi Janumet: Nkhani zatsatanetsatane

Werengani zomwe muyenera kuchita ngati Januvia ndi Galvus sangathe kukupatsani inu kapena mankhwala anu a shuga asiya kuthandiza. Phunzirani momwe mungasungire shuga yanu yamagazi ndikusunga pamapiritsi okwera mtengo.

Malangizo ogwiritsira ntchito

Zotsatira za pharmacological

Sitagliptin ndi choletsa wa enzyme DPP-4. Kuchulukitsa kuchuluka kwa mahomoni am'banja la intretin. Zinthu izi zimathandizira kapamba kuti apange insulini poyankha chakudya, komanso amachepetsa kubisalira kwa glucagon. Chifukwa cha izi, shuga wamagazi amachepa pang'ono popanda chiwopsezo cha hypoglycemia. Amathiridwa impso ndi mkodzo ndi 80-90%, ndi chiwindi - ndi 10-20%. Odwala omwe amatenga Janumet ayenera kuwerenga pano za zotsatira za metformin.

Zizindikiro zogwiritsidwa ntchito

Type 2 shuga. Zakudya zabwino komanso zolimbitsa thupi ziyenera kukhala njira zazikulu zochiritsira, ndipo mapiritsi ndi insulin ayenera kukhala othandiza. Onani nkhani yakuti “Zakudya za Matenda Ati a 2.” Mankhwala a Januvia (sitagliptin) amatha ndipo ayenera kuphatikizidwa ndi metformin. Mapiritsi osakanizira a Yanumet amapezeka okhala ndi sitagliptin ndi metformin pansi pa chigoba chimodzi.

Kutenga Januvia, Janumet kapena mapiritsi ena aliwonse a shuga, muyenera kutsatira zakudya.

Contraindication	Mtundu woyamba wa shuga. Mimba komanso nthawi yoyamwitsa. Mavuto owopsa chifukwa cha shuga wambiri ndi ketoacidosis, hyperglycemic coma. Zaka mpaka 18. Thupi lawo siligwirizana ndi yogwira kapena mankhwala othandizira. Metformin ili ndi zotsutsana zambiri kuposa sitagliptin. Werengani zambiri za iwo apa.
Malangizo apadera	Chithandizo chophatikizira cha matenda ashuga a mtundu 2 sichinafufuzidwe ndi jakisoni wa Januvia ndi insulin, komanso zotumphukira za sulfonylurea. Choyamba, pitani pa zakudya zamafuta ochepa. Ndi shuga omwe ali ndi 9,0 mmol / L ndiwotunda, nthawi yomweyo yambani kubayirira insulini, kenako pulagi pamapiritsi. Werengani nkhani yakuti "Type 2 shuga insulin" kuti mumve zambiri.

Mlingo

Mlingo wamba wa sitagliptin (Januvia) ndi 100 mg patsiku. Imwani mankhwalawa nthawi 1 patsiku, kaya mukudya chiyani. Pankhani ya kulephera kwapakati kwa impso (creatinine chilolezo 30-50 ml / mphindi, seramu creatinine wambiri 1,7-3 mg / dl mwa amuna, 1.5-2.5 mg / dl mwa akazi), mlingo umachepetsedwa mpaka 50 mg patsiku. A kwambiri aimpso kulephera, 25 mg patsiku. Janumet ayenera kumwedwa katatu patsiku ndi chakudya. Muthanso kutenga piritsi imodzi ya metformin yoyera. Werengani apa zambiri za kusankha kwa mankhwalawa.

Zotsatira zoyipa

Mankhwala a Januvia amalekeredwa bwino, zomwe zimapangitsa kuti mavuto ena asakhalepobe ngati placebo. Nthawi zina, matenda amtundu wa kupuma amachitika. Mlingo wa uric acid m'magazi umakwera pang'ono ndi pafupifupi 0 mg mg / dl. Izi siziyenera kuwonjezera ngozi ya gout. Ngati mukutenga Janumet, werengani apa za zoyipa za metformin. Amakhala pafupipafupi komanso ndizovuta kwambiri kuposa sitagliptin.

Mimba komanso Kuyamwitsa	Mankhwala Januvia ndi Janumet satchulidwa kuti azilamulira shuga yayikulu m'magazi panthawi yomwe ali ndi pakati. Palibe mapiritsi a shuga omwe amagwiritsidwa ntchito. Ngati ndi kotheka, jekeseni insulin. Yesani kuchita popanda iwo, kutsatira zakudya zabwino. Werengani nkhani zakuti “Amayi Azipakati” ndi “Gestational Diabetes” kuti mumve zambiri.
Kuchita ndi mankhwala ena	Sizokayikitsa kuti sitagliptin angayanjane ndi mankhwala ena onse. Koma chifukwa cha metformin pophatikizidwa ndi mapiritsi a Janumet, pamakhala chiwopsezo cha izi. Werengani zokhudzana ndi machitidwe ake osokoneza bongo pano. Lankhulani ndi dokotala wanu zamankhwala zilizonse, zowonjezera pazakudya, ndi zitsamba zomwe mukumwa.
Bongo	Milandu ya limodzi mlingo wa Januvia mu Mlingo mpaka 800 mg akufotokozedwa. Odwala analibe zofunikira kwambiri m'thupi, kupatula kusintha pang'ono kwa gawo la QT pa mtima. Mankhwala osokoneza bongo a Metformin atha kukhala vuto lalikulu kwambiri. M'pofunika kuchita chapamimba chapamimba, kuchita zodziwitsa komanso kuthandizira. Kutsegula m'mimba kumathandizira pakuchotsa sitagliptin m'thupi.
Kutulutsa Fomu	Januvia - mapiritsi a beige, ozungulira. Mbali imodzi ndi a biconvex, olembedwa "277". Mbali inayo ndi yosalala. Yanumet imapezeka m'mapiritsi okhala ndi 50 mg ya sitagliptin ndi mitundu yayikulu ya metformin - 500, 850 ndi 1000 mg. Kuti mudziwe mlingo woyenera wa metformin, werengani nkhaniyi.
Migwirizano ndi magwiritsidwe akusungidwa	Pewani kufikira ana pa kutentha osapitirira 30 ° C. Moyo wa alumali ndi zaka 2.
Kupanga	The yogwira thunthu ndi sitagliptin mu mawonekedwe a phosphate monohydrate. Zothandiza - cellcrystalline cellulose, calcium hydrogen phosphate, croscarmellose sodium, magnesium stearate, sodium stearyl fumarate. Mapiritsi a Shell - Opadry II beige 85 F17438, mowa wa polyvinyl, titanium dioxide, macrogol (polyethylene glycol) 3350, talc, iron oxide wachikasu ndi ofiira.

Mankhwala a Januvia alibe ma analogu otsika mtengo, chifukwa kuvomerezeka kwa patent kwa sitagliptin sikunathe. Ngati simungathe kugula mankhwalawa, sinthani kwa metformin yangwiro - koposa zonse ndi Glucofage kapena Siofor. Ndikusintha kwa chakudya chamafuta ochepa, chakudya chimachulukirachulukira. Komabe, zakudya zama protein ndizofunikira kwa inu. Ziyenera kukhala zinthu zofunika kuzigwiritsa ntchito. Ndipo mutha kupulumutsa pamapiritsi a shuga amtengo wapatali.

Mankhwala ofanana ndi Januvius ndi Galvus (vildagliptin), Ongliza (saxagliptin), Trazenta (linagliptin), Vipidia (alogliptin) ndi Satereks (gozogliptin). Amapangidwa ndi makampani opikisana azamankhwala.

Mankhwalawa onse amatetezedwa ndi ma Patenti. Zachidziwikire, opanga adagwirizana pakati pawo kuti mitengo ikhale yayitali. Zomwe zimagwira zimatchedwa glyptins. Amachepetsa shuga m'magazi. Sikufunika kuwalipira. Mapiritsi okhala ndi metformin yoyera amtengo wapatali ndipo amathandizanso pafupifupi.

Momwe mungamwe mankhwalawa?

Mankhwala a Januvia amayenera kumwedwa 1 pa tsiku pa mlingo womwe dokotala watchulidwa. Mutha kumwa pamaso panu kapena musanadye chakudya, monga mungafunire. Yanumet nthawi zambiri imatengedwa kawiri patsiku ndi chakudya kuti muchepetse mavuto a metformin. Monga lamulo, ndizomveka kumwa mapiritsi ena a metformin yoyera pachakudya chachitatu kuti mufikire kuchuluka kwa mankhwalawa tsiku lililonse 2550-3000 mg. Kapenanso mutha kutenga mafuta a Metformin Pomakhala Pang'onopang'ono usiku kuti mukhale ndi shuga m'magazi abwino kwambiri. Musakhale aulesi kwambiri kuti mumvetsetse kusankha kwa mitundu ndi mitundu ya metformin. Afotokozedwa mwatsatanetsatane apa.

Januvius kapena Galvus: zili bwino ndi chiyani?

Mankhwalawa Januvia (sitagliptin) ndi Galvus (vildagliptin) ndi ofanana kwambiri. Amachita mpikisano wina ndi mnzake chifukwa cha mitima ndi matumba a omwewo. Opanga akupititsa patsogolo mapiritsi awa pakati pa madokotala ndi odwala omwe ali ndi matenda ashuga. Alinso ndi ma fanizo ena angapo omwe atchulidwa pamwambapa. Komabe, m'maiko olankhula Chirasha sakhala otchuka kwambiri.

Pakadali pano, palibebe chidziwitso chokwanira chokwanira kuyankha funso lomwe ndi labwino - Januvius kapena Galvus. Komabe, zili bwino kunena kuti ndibwino kumwa mapiritsi okhala ndi masigliptin kapena vildagliptin ngakhale metformin. Lankhulani ndi dokotala wanu ngati muyenera kusinthira ku Yanumet kapena Galvus Met.

Metformin ndiyotsika mtengo ndipo imachepetsa shuga ya magazi kuposa nthito ndi vildagliptin. Samalani ndi mankhwala Galvus Met. Amakhala ndi ndemanga zambiri za anthu odwala matenda ashuga kuposa mankhwala ena ofanana. Metformin imakhala ndizotsatira zoyipa kuposa ma glissins. Koma, monga lamulo, si owopsa. Ayenera kupiriridwa kuti akwaniritse zotsatira zake - kukonza magazi ndi magazi a glycated hemoglobin.

Kodi mungasinthe bwanji Janumet?

Odwala akufuna kusintha Janumet ndi mankhwala ena m'malo otsatirawa:

Mapiritsi mothandizidwa samathandiza, musachepetse magazi.
Zotsatira zoyipa kwambiri.
Mankhwalawa amathandiza, zotsatira zoyipa ndizobala, koma mtengo wake ndiwokwera kwambiri.

Ngati Yanumet kwenikweni sikuthandizira, siyimachepetsa shuga la magazi, ndiye kuti iyenera m'malo mwa jakisoni wa insulin. Palibe mapiritsi ena omwe amayesedwa. Zikondwerero za wodwalayo mwina zinali zitatha, ndipo matendawo a 2 apamwamba kwambiri anasintha kukhala mtundu woyamba wa shuga. Werengani nkhani ya "Type 2 Diabetes Insulin" ndikuchita zomwe ikunena. Kumbukirani kuti kudya zakudya zamafuta ochepa kuyenera kukhala chithandizo chachikulu, ngakhale mutaba jakisoni kapena ayi.

Zotsatira zosasangalatsa za mankhwala a Janumet nthawi zambiri zimayambitsa metformin monga gawo la mankhwalawa. Mwawerenga pamwambapa kuti chosakanikirana chachikulu cha sitagliptin sichimabweretsa mavuto kwa odwala. Samalekeredwa kwambiri kuposa placebo. Zokhudza zoyipa za metformin, muyenera kuzisintha, kupirira, osayang'ana zina. Chifukwa metformin ndi mankhwala apadera ochita bwino komanso otetezeka. Zitha kuyambitsa matenda otsekula m'mimba komanso mavuto ena, koma mankhwalawa amachepetsa shuga m'magazi popanda kuwononga thupi. Kuphatikiza apo, ndi yotsika mtengo. Kuti muchepetse mavuto, idyani Janumet ndi metformin yoyera ndi chakudya, musanadye kapena musanadye. Phunzirani kuchuluka kwa mankhwalawa pano ndi kuwonjezeka kwapang'onopang'ono kwa mlingo.

Kuti musunge ndalama, mutha kusintha kuchokera ku mankhwala a Januvia kapena Yanumet kukhala metformin woyenera - wopambana ndi Glucofage kapena Siofor, osati mapiritsi a kupanga. Mtengo wa mankhwala umachepetsedwa kwambiri, ndipo chiwongolero cha matenda ashuga chimakhalabe chofanana. Makamaka ngati mutsatira zakudya zamafuta ochepa ndipo simukhala aulesi kuchita masewera olimbitsa thupi.

Kodi wothandizira hypoglycemic ndi chiyani?

Mankhwala Yanumet amaphatikizidwa ndi gulu la mankhwala omwe ali ndi vuto la hypoglycemic. Ichi ndichifukwa chake, nthawi zambiri amalembera shuga mellitus wa fomu yodziyimira payekha.

Kuchita kwake kumapangidwira ndi zosakaniza zingapo zomwe ndi gawo lamankhwala.

Dziko lomwe Yanniet idachokera ndi United States of America, yomwe imalongosola mtengo wokwera kwambiri wa mankhwalawa (mpaka ma ruble 3,000, kutengera mlingo).

Mapiritsi a Janumet amagwiritsidwa ntchito motere:

Kuchepetsa shuga wamagazi, makamaka ngati kudya zakudya zamagulu limodzi ndi zolimbitsa thupi zolimbitsa thupi zikuwonetsa zotsatira zoyipa,
ngati monotherapy yogwiritsira ntchito imodzi yokha yogwiritsira ntchito siyinabweretse zotsatira zomwe mukufuna,
Itha kugwiritsidwa ntchito ngati njira yovuta yothandizira pamodzi ndi zotumphukira za sulfrnylurea, insulin kapena PPAR-gamma antagonists.

Mankhwalawa ali ndi magawo awiri omwe amagwira ntchito omwe ali ndi vuto la hypoglycemic:

Sitaglipin ndi nthumwi ya DPP-4 enzyme inhibitor group, yomwe, ndi kuchuluka kwa shuga m'magazi, imalimbikitsa kaphatikizidwe ndi katulutsidwe ka insulin ndi maselo a pancreatic beta. Chifukwa cha izi, pali kuchepa kwa kapangidwe ka shuga m'chiwindi.
Metformin hydrochloride ndi woimira gulu lachitatu-greatuanide gulu, lomwe limathandizira kuletsa kwa gluconeogeneis. Kugwiritsa ntchito mankhwala ozikidwa ndikulimbikitsa glycolysis, komwe kumapangitsa kuti shuga azikhala bwino ndi maselo komanso minyewa ya thupi. Kuphatikiza apo, pali kuchepa kwa mayamwidwe am'magazi ndimaselo a m'matumbo. Ubwino wawukulu wa metformin ndikuti siziyambitsa kuchepa kwambiri kwa glucose (m'munsimu muyezo) ndipo sizitsogolera pakupanga hypoglycemia.

Mlingo wa mankhwala umatha kusintha mamiligalamu 500 mpaka chikwi chimodzi mwazomwe zimagwira - metformin hydrochloride. Ichi ndichifukwa chake, pharmacology yamakono imapatsa odwala mitundu yamitundu iyi:

Chiwerengero choyamba pakuphatikizidwa kwa mankhwalawa chikuwonetsa kuchuluka kwa yogwira zigawo sitaglipin, yachiwiri ikuwonetsa mphamvu ya metformin. Monga zinthu zothandizira zimagwiritsidwa ntchito:

Microcrystalline mapadi.
Povidone.
Sodium stearyl fumarate.
Sodium lauryl sulfate.
Mowa wa Polyvinyl, titanium dioksidi, macrogol, talc, oxide wachitsulo (chipolopolo cha kukonzekera kwa piritsi chimakhala ndi iwo).

Chifukwa cha chida chachipatala Yanumet (Yanomed), ndikotheka kukwaniritsa zopinga zama glucagon, zomwe, ndi kuwonjezeka kwa insulin, kumabweretsa kukula kwa shuga m'magazi.

Ndikofunikira kwa odwala matenda ashuga kuti mapiritsi omwe amamwa atengere zotsatira zabwino pamtengo wotsika. Pali mankhwala omwe ali ndi zinthu zina pokhapokha, palinso ena omwe amagwiritsidwa ntchito palimodzi. Nthawi zambiri amakhala othandiza pamankhwala. Chimodzi mwazida zotere, mogwirizana ndi malangizo ogwiritsira ntchito, ndi Yanumet. Ganizirani momwe zimachitikira komanso zomwe zimasiyanitsa ndi mankhwala ofanana pamsika wa mankhwala othandizira odwala matenda ashuga.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Imapezeka mu mawonekedwe a mapiritsi okhala ndi filimu. Pali zidutswa 14 pachimake chimodzi, pamakatoni a makatoni pamatha kukhala matuza 1, 2, 4, 6 kapena 7.

500, 800 kapena 1000 mg wa metformin,
50 mg ya sitagliptin monohydrate phosphate,
cellcrystalline mapadi,
povidone
sodium fumarate,
sodium lauryl sulfate.

Zotsatira za pharmacological

Chifukwa cha zomwe zigawo ziwiri zimapanga - metformin ndi sitagliptin - mphamvu ya Hypoglycemic imatheka. Zimathandizana, zimachepetsa shuga.

Sitagliptin ndi choletsa wa DPP-4, ali ndi zochita zomwe zimayambitsa ma insretin, omwe, nawonso amawongolera shuga homeostasis. Amathandizira kuwonjezera insulin ya insulin ngati pakufunika izi m'thupi. Poterepa, kubisalira kwa glucagon ndipo, chifukwa chake, kuphatikiza kwa glucose m'chiwindi kumapanikizidwa.

Metformin ndi biguanide yomwe imawonjezera kulolera kwa glucose kenako imachepetsa kukhazikika kwake m'magazi ndi kaphatikizidwe m'chiwindi. Kuphatikiza apo, chidwi cha maselo kupita ku glucose chimakulitsidwa.

Pharmacokinetics

Mlingo wa Yanumet ndi wofanana ndi makonzedwe apadera a metformin ndi sitagliptin. The bioavailability wa chinthu choyamba ndi 87%, 60%.

Zochita zapamwamba za sitagliptin zimachokera ku 1 mpaka 4 mawola atatha. Metformin imayatsidwa pambuyo maola 2. Ngati mphamvu yoyamba siyikhudzidwa ndi chakudya, ndiye kuti yachiwiriyo imachepetsa kuphatikiza ndi chakudya.

Njira yayikulu yochotsera kudzera mu impso. Kagayidwe kochepa.

Type 2 shuga mellitus ndi chakudya chosakwanira komanso masewera olimbitsa thupi.Itha kugwiritsidwa ntchito ngati chida chodziyimira pawokha, kapena kuphatikiza ndi sulfonylurea kapena insulin.

Contraindication

Hypersensitivity pamagawo ake,
Zomwe zimakhudza kugwira ntchito kwa impso (kuchepa madzi m'thupi, matenda),
Mtundu woyamba wa shuga
Matenda omwe amatsogolera minofu hypoxia (myocardial infarction, mtima kulephera),
Ntchito yaimpso kapena chiwindi.
Matenda a shuga ketoacidosis
Mowa
Mimba komanso kuyamwa.

Zotsatira zoyipa

Mutu
Pancreatitis
Kusanza, kupweteka kwam'mimba,
Anorexia
Kulawa kwazitsulo mkamwa
Kubweza
Kutsekula m'mimba kapena kudzimbidwa
Pakamwa pakamwa
Thupi lawo siligwirizana
Kugona
Chifuwa
Anemia
Lactic acidosis
Hypoglycemia,
Peripheral edema.

Bongo

Ngati bongo, lactic acidosis imayamba. Potere, kuchotsedwa kwa zotsalira za mankhwala m'thupi kumafunika, ndiye kuti hemodialysis imachitika ndipo mkhalidwe wa wodwalayo umayang'aniridwa.

Zizindikiro za hypoglycemia ndizothekanso. Ndi mawonekedwe ofatsa, chakudya chokhala ndi mavitamini ambiri ndi chofunikira. Pankhani yocheperako komanso yolimba, mudzafunika jakisoni wa shuga kapena njira ya dextrose, kuti muthandize wodwalayo kudziwa komanso kudya zakudya zomwe zili ndi chakudya. Kenako, pempho loyenerera kupita kwa adokotala kuti alandire mankhwala liyenera kusintha.

Kuyanjana kwa mankhwala osokoneza bongo

Iyenera kuganizira za kuyanjana kwa njira zina ndi gawo lililonse la Yanumet.

Metformin itha kufooka:

thiazide okodzeya,
glucagon,
corticosteroids
estrogens
phenothiazines,
nicotinic acid
mahomoni a chithokomiro,
odana ndi calcium
phenytoin
amphanomachul
isoniazid.

insulin
NSAIDs
zochokera sulfonylurea,
acarbose,
clofibrate ofanana nawo
Mao ndi ACE zoletsa,
cyclophosphamide,
oxytetracycline
opanga beta.

Cimetidine amatha kuletsa zochitika za metformin, zomwe zimawopseza kukula kwa acidosis.

Sitagliptin ikhoza kuwonjezera kuchuluka kwambiri kwa Digoxin, Januvia, Cyclosporin. Kwenikweni, kuyanjana kwa mankhwala ndi mankhwalawa sikupereka zizindikiro zofunikira, ndiye kuti, palibe zotsutsana ndi mgwirizano.

Kuthandizirana ndi sulfonylureas kapena insulini kungayambitse hypoglycemia pamene mlingo watha.

Malangizo apadera

Maola 48 asanachitike komanso atatha kuphunzira pogwiritsa ntchito mankhwala okhala ndi ayodini, mankhwalawa adatha.

Munthawi yonse ya chithandizo, ndikofunikira kuwunika nthawi zonse za impso ndikuyezetsa mayeso pafupipafupi.

Pali chiopsezo chakukhudza kuyendetsa magalimoto, chifukwa chake ndikofunikira kusankha pazoyenera izi panthawi yonse ya chithandizo. Izi ndizotheka makamaka ngati atengedwa ndi insulin kapena sulfonylurea.

Mankhwala amatha kuphatikiza zizindikiro za kapamba, chifukwa cha impso. Chifukwa chake, mkhalidwe wa wodwalayo uyenera kuyang'aniridwa kuti apewe kukula.

Ndikofunikira kuti wodwalayo azindikire zizindikiro za lactic acidosis ndipo ngati zichitika, funsani dokotala nthawi yomweyo. Kugonekedwa kuchipatala msanga kumapewetsa zovuta.

Imatulutsidwa kokha pamankhwala!

Fananizani ndi fanizo

Mankhwalawa ali ndi ma analogi angapo omwe amalimbikitsidwa kuwerengedwa kuti aziyerekeza katundu.

Osagwiritsidwa ntchito pochiza amayi apakati ndi ana, ogwiritsidwa ntchito mosamala odwala okalamba.

Zopatsa: kwa odwala akuluakulu okha, zoletsedwa panthawi yomwe muli ndi pakati.

Zoletsedwa kuti zizigwiritsidwa ntchito mwa ana, okalamba, oyembekezera komanso okonza.

Kutumizidwanso kwa mankhwala kapena kugwiritsa ntchito ma analogues kumachitika kokha mwa chilolezo cha katswiri. Kudzipatsa nokha koletsedwa!

Uwu ndi mankhwala othandiza kwambiri, woyenera anthu ambiri, ndipo mtengo wake wokwera umatha.

Katherine: "Yanumet" adalembedwa ndi adotolo. Ndakhala ndikutenga kwa zaka ziwiri, ndikusangalala ndi chilichonse. Zochita zake zimandikomera, palibe zoyipa zomwe zimachitika. Shuga amabwereranso kumbuyo ndikupitilira. Komanso, kulemera kwake kunachepera ndi ma kilogalamu 7, apo ayi anali ndi mavuto. "

Daria: “Ndinalandira mapiritsiwa kwaulere. Amandigwira bwino, ndikaphatikizidwa ndi zakudya komanso masewera olimbitsa thupi, ndidatsitsa 12 kg ndikuyika mulingo wama glucose. Zachidziwikire, ndikadagula ndalama yanga, zikadakhala zovuta, ndizodula. Koma luso limakhalabe labwino. ”

Igor: “Ndikhulupirira kuti Yanumet ndiye njira yopulumutsira odwala matenda ashuga. Amapereka zotsatira mwachangu, ndikamadya komanso ndikuchita masewera olimbitsa thupi amathandizira kuti thupi likhale labwino, limachepetsa shuga. Pali mphamvu yakuchepera thupi, koma adotolo adalongosola kuti simungamwe mapiritsi awa chifukwa chokha - katundu pazimpso ndi wamphamvu. "Zonse zili bwino kwa iwo, chifukwa chake ndimapitilirabe kulandira mankhwalawa ndipo ndikusangalala ndi zotsatira zake."

Valentine: “Abambo anga anapezeka ndi matenda a shuga. Dotolo adayamba kupangira metformin ndi sitagliptin payokha. Kenako adazindikira kuti pali mankhwala amodzi omwe amasintha mapiritsi awiri, chifukwa ali ndi zinthu zonsezi. Impso za abambo ake zimakhala zathanzi, motero adotolo adalola kuti atenge. "Yanumet" idathandizira kukonza shuga, komanso kuchotsa mafuta owonjezera omwe amachokera kwa abambo chifukwa cha matendawa. Amachita mantha kuti mwina pali zovuta pa impso kapena zotsatira zina, koma angathe kuchita popanda iwo. Abambo amakhutira ndi mankhwalawa, amathandizidwa mpaka pano. "

Pomaliza

Yanumet ili ndi malingaliro abwino kuchokera kwa odwala matenda ashuga komanso madokotala awo. Njira yothandizira odwala matenda ashuga awa imapereka zotsatira zachangu komanso zachikale, ndizoyenera kwa anthu ambiri ndipo sizimayambitsa mavuto. Amayamikiridwa chifukwa cha kupezeka kwapamwamba kwambiri komanso kupezeka kwa mapindu, ngakhale zimadziwika kuti mtengo m'mafakisi wamba ndiwokwera. Koma kugwira ntchito bwino kwa mankhwalawa kumakwaniritsa izi.

Mapiritsi a Yanumet ogwiritsira ntchito amagwiritsa ntchito mankhwala a hypoglycemic omwe amagwiritsidwa ntchito kulipirira matenda a shuga a 2. Kuchita kwake kumakonzedwa ndi kapangidwe kazinthu kazomwe amapanga. Kodi ndi yani ndipo ndiigwiritsa ntchito moyenera?

Amakonda kutumizidwa ngati kusintha kwa moyo komanso metformin monotherapy kapenanso chithandizo chovuta sichinabweretse zotsatira zomwe zikuyembekezeka. Nthawi zina amalembedwa kwa anthu omwe amachita nawo masewera olimbitsa thupi kuti athe kuwongolera mbiri yawo ya glycemic. Kuphatikiza pakudziwitsidwa kwathunthu ndi malangizo, musanagwiritse ntchito pa chilichonse, kufunsira kwa dokotala ndikofunikira.

Yanumet: kapangidwe kake ndi mawonekedwe ake

Chofunikira chachikulu pa fomula ndi metformin hydrochloride. Mankhwalawa amawaika mu 500 mg, 850 mg kapena 1000 mg piritsi limodzi. Sitagliptin imathandizira pophika wamkulu, mu kapisozi imodzi imakhala 50 mg pa mlingo uliwonse wa metformin. Pali zokometsera zina zamkati zomwe sizili ndi chidwi ndi luso lamankhwala.

Makapisozi otukusira osindikizidwa amatetezedwa ku fake ndi mawu olembedwa "575", "515" kapena "577", kutengera mlingo. Phukusi lililonse la makatoni limakhala ndi mbale ziwiri kapena zinayi za zidutswa 14. Mankhwala omwe mumalandira amathandizidwa.

Bokosi likuwonetsanso moyo wa alumali wa mankhwalawo - zaka ziwiri. Mankhwala omalizira ayenera kutayidwa. Zofunikira pakusungidwa ndizoyenera: malo owuma osafikiridwa ndi dzuwa ndi ana omwe ali ndi kutentha kwa madigiri 25.

Kuthekera kwama pharmacological

Yanumet ndi njira yolingalira ya mankhwala awiri ochepetsa shuga omwe ali ndi zowonjezera (zowonjezera kwa wina ndi mzake): metformin hydrochloride, yomwe ndi gulu la Biguanides, ndi sitagliptin, choletsa DPP-4.

Synagliptin

Gawoli lapangidwa kuti lizigwiritsidwa ntchito pakamwa. Limagwirira ntchito ya sitagliptin zachokera kukondoweza kwa ma insretins. DPP-4 ikakhala yolephereka, mulingo wa GLP-1 ndi ma HIP peptides, omwe amawongolera glucose homeostasis, amawonjezeka. Ngati ntchito yake ndiyabwino, ma insretin amayambitsa kupanga insulin pogwiritsa ntchito maselo a β-cell. GLP-1 imalepheretsanso kupangidwa kwa glucagon ndi ma α-cell mu chiwindi. Algorithm iyi siyofanana ndi lingaliro lamavuto am'makalasi a sulfonylurea (SM) omwe amalimbikitsa kupanga kwa insulin pamlingo wina uliwonse wa glucose.

Ntchito zotere zimatha kuyambitsa hypoglycemia osati odwala matenda ashuga okha, komanso odzipereka athanzi.

DPP-4 enzyme inhibitor mu Mlingo wolimbikitsidwa sikulepheretsa ntchito ya michere ya PPP-8 kapena PPP-9. Mu pharmacology, sitagliptin siili ofanana ndi mawonekedwe ake: GLP-1, insulin, zochokera kwa SM, meglitinide, biguanides, α-glycosidase inhibitors, γ-receptor agonists, amylin.

Chifukwa cha metformin, kulolera shuga mu mtundu 2 wa shuga kumawonjezereka: kukhazikika kwawo kumachepa (onse a postprandial ndi basal), insulin kukana kumachepa. Mphamvu ya momwe mankhwalawo amathandizira ndi yosiyana ndi mfundo za kagwiritsidwe ntchito ka mankhwala ochepetsa shuga. Poletsa kupanga kwa glucogen ndi chiwindi, metformin imachepetsa kuyamwa kwake ndi makhoma am'mimba, imachepetsa kukana kwa insulini, ndikupititsa patsogolo ziphuphu.

Mosiyana ndi kukonzekera kwa SM, metformin sichimayambitsa kupweteka kwa hyperinsulinemia ndi hypoglycemia ngakhale odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, kapena gulu lowongolera. Panthawi ya mankhwalawa ndi metformin, kupanga insulini kumakhalabe pamlingo womwewo, koma kuthamanga kwake komanso kutsika kwa tsiku ndi tsiku kumachepa.

Zogulitsa

The bioavailability wa sitagliptin ndi 87%. Kugwiritsanso ntchito kwamafuta komanso zakudya zopatsa mphamvu zambiri sizikukhudza kuchuluka kwa mayamwidwe. Mulingo wambiri wa mankhwala ophatikizira m'magazi umakhazikika pambuyo pa maora 1-4 pambuyo poti wachotsedwa m'mimba.

The bioavailability wa metformin pamimba yopanda kanthu mpaka 60% pa mlingo wa 500 mg. Ndi muyezo umodzi waukulu waukulu (mpaka 2550 mg), mfundo ya kuchuluka kwake, chifukwa cha kuyamwa kochepa, inaphwanyidwa. Metformin imayamba kugwira ntchito patatha maola awiri ndi theka. Mlingo wake umafika 60%. Mulingo wambiri wa metformin umakhazikitsidwa pambuyo pa tsiku limodzi kapena awiri. Pakudya, mphamvu ya mankhwalawa imachepa.

Kugawa

Kuchuluka kwa kagawidwe ka sungliptin kogwiritsa ntchito 1 mg ya gulu loyang'anira omwe adayeserera anali 198 l. Mlingo womangidwa m'mapuloteni a magazi ndi ochepa - 38%.

Pakuyesera kofananako ndi metformin, gulu lolamulira linapatsidwa mankhwala mu kuchuluka kwa 850 mg, voliyumu yogawa nthawi yomweyo inali yamtundu wa malita 506.