Exenatide: mtengo ndi fanizo la Bayeta

Alendo 12 adafotokoza zaka zodwala

Zolemba zosangalatsa

Momwe mungasankhire analog yoyenera
Mu pharmacology, mankhwala nthawi zambiri amagawidwa m'magulumagulu ndi ma analogi. Kapangidwe kazofananira kameneka kamaphatikizira amodzi kapena angapo amomwe omwewo omwe ali ndi mphamvu yothandizira thupi. Ndi ma analogi amatanthauza mankhwala okhala ndi zinthu zosiyanasiyana zogwira ntchito, koma zochizira matenda omwewo.

Kusiyana pakati pa matenda a ma virus ndi bakiteriya
Matenda opatsirana amayambitsidwa ndi ma virus, mabakiteriya, bowa ndi protozoa. Njira ya matenda oyambitsidwa ndi ma virus ndi ma bacteria nthawi zambiri imakhala yofanana. Komabe, kusiyanitsa chomwe chimayambitsa matendawa kumatanthauza kusankha njira yoyenera yomwe ingathandize kuthana ndi vuto losachedwa kudwala ndipo sizivulaza mwana.

Chifuwa ndi chomwe chimayambitsa chimfine pafupipafupi
Anthu ena amadziwa vuto lomwe mwana nthawi zambiri amakhala nalo kwa chimfine. Makolo amamutengera kwa madotolo, kukamuyeza mayeso, kugwiritsa ntchito mankhwala osokoneza bongo, ndipo monga chotulukapo chake, mwana amalembetsa kale ndi dotolo wa ana monga nthawi zambiri amadwala. Zoyambitsa zenizeni za kupuma pafupipafupi sizidziwika.

Urology: mankhwalawa a chlamydial urethritis
Chlamydial urethritis nthawi zambiri imapezeka pochita urologist. Amayamba chifukwa cha majeremusi a Chlamidia trachomatis, omwe ali ndi mphamvu ya mabakiteriya komanso mavairasi, omwe nthawi zambiri amafunikira njira yothandizira antibacterial. Imatha kuyambitsa kutupa kosakhudzana ndi urethra mwa amuna ndi akazi.

Malangizo ogwiritsira ntchito mankhwalawa

Mankhwala okhawo okhala ndi exenatide ndi Baeta. Kuphatikiza pa gawo lalikulu, pali zochepa zazinthu zina zowonjezera: sodium acetate trihydrate, mannitol, metacresol, acetic acid ndi madzi osungunuka.

Zimapangidwa ndi makampani awiri aku Sweden - AstraZeneca ndi Bristol-Myers squibb Co (BMS). Baeta ili ndi mawonekedwe amodzi okha - 250 mg ampoules omwe ali ndi yankho lomveka, chifukwa chilichonse chimakhala cholembera chapadera chokhala ndi voliyumu ya 1.2 kapena 2.4 ml.

Mankhwalawa amagulitsidwa ndi mankhwala, ndiye adokotala okhawo omwe angapereke kwa wodwala. Wodwala akapeza ma ampoules, ayenera kuwerenga mosamala malangizo omwe angagwiritsidwe ntchito.

Mankhwalawa amagwiritsidwa ntchito limodzi ndi monotherapy komanso ndi chithandizo chowonjezera cha mtundu 2 wa matenda a shuga, pakakhala kotheka kuwongolera glycemia. Malangizowa ali ndi mndandanda wamankhwala omwe mungathe kuphatikiza mankhwala a Bayeta:

• khwawa
• zochokera sulfonylurea,
• Thokozani,
• kuphatikiza kwa thiazolidinedione ndi metformin,
• kuphatikiza kwa sulfonylurea ndi metformin.

Mlingo wa mankhwalawa ndi 5 mcg patsiku 1 ola limodzi asanadye. Amabayidwa pansi pakhungu pakhungu, pamphumi kapena pa ntchafu. Ngati mankhwalawa adachita bwino, patatha masiku 30, muyezo umakulitsidwa mpaka 10 mgg kawiri pa tsiku. Pankhani yophatikiza mankhwalawa ndi mankhwala a sulfonylurea, mankhwalawa amayenera kuchepetsedwa kuti muchepetse kuchepa msanga kwa shuga. Pakukhazikitsa yankho, malamulo otsatirawa ayenera kutsatiridwa:

1. Mankhwalawa sagwiritsidwa ntchito mukatha kudya,
2. musati muzibayira kapena kudzera m'mitsempha,
3. Ngati yankho lasintha kapena kukhala ndi tinthu tina, siligwiritsidwa ntchito,
4. Pa chithandizo, kupanga anti-antibody ndikotheka.

Mankhwalawa amayenera kusungidwa m'malo opanda ana kutali ndi kutentha kwa 2-8C.

Moyo wa alumali ndi zaka ziwiri, ndipo yankho mu cholembera ndi masiku 30 lotentha osaposa 25 digiri.

Contraindication ndi zoyipa zimachitika

Monga mankhwala ena, mankhwala a Bayeta ali ndi zotsutsana:

• mtundu 1 shuga
• ketoacidosis (mavuto mu chakudya kagayidwe kachakudya),
• Kulephera kwaimpso (CC mtengo wochepera 30 ml / min),
• kukhudzidwa ndi magawo a mankhwala,
• zida zam'mimba osagaya chakudya,
• kubala ndi kuyamwitsa,
• ana ndi achinyamata ochepera zaka 18.

Pazifukwa zilizonse, mwachitsanzo, kugwiritsa ntchito mosayenera mankhwalawa, zotsatira zoyipa zingachitike:

1. thupi lawo siligwirizana - urticaria, totupa pakhungu, kuyabwa,
2. kuphwanya kwam'mimba dongosolo - nseru ndi kusanza, kugona mwachangu, kudzimbidwa kapena kutsegula m'mimba, kuchepa chilimbikitso ndi kulemera,
3. mavuto a chapakati mantha dongosolo - mkwiyo, kutopa, chizungulire ndi matenda ashuga ndi mutu,
4. chiwindi kapena matenda a impso,
5. kuchuluka seramu creatinine,
6. hypoglycemic state, hyperhidrosis, kapamba.

Zikatero, wodwalayo ayenera kufunsa dokotala yemwe amasintha mankhwalawo.

Mungafunike kuchepetsa mlingo kapena kusiya kumwa mankhwalawa.

Mtengo, ndemanga ndi fanizo la mankhwala

Mankhwala Baeta atha kugulidwa ku malo ogulitsa mankhwala kapena kuyika oda pa intaneti. Popeza mankhwalawo amalowetsedwa kunja, mtengo wake umakhala, motero, wokwera kwambiri. Chifukwa chake, sikuti aliyense angathe kugula.

Mtengo umasiyanasiyana malinga ndi kuchuluka kwa yankho, mtengo wa mayendedwe komanso malire a wogulitsa:

• 1.2 ml syringe cholembera - kuchokera 4246 mpaka 6398 ma ruble aku Russia,
• 2.4 ml syringe cholembera - kuchokera ku 5301 mpaka 8430 rubles aku Russia.

Odwala ambiri omwe adalandira yankho la Bayet adakhutira ndi mankhwalawa. Choyamba, chimagwiritsidwa ntchito kamodzi patsiku, ndipo chachiwiri, chimatsitsa shuga ndi kulemera kwa thupi mwa munthu wonenepa kwambiri.

Komabe, atatulutsira mankhwalawo, opangawo adachita kafukufuku wotsatsa malonda omwe odwala omwe adasankhidwa mwachisawawa adatengapo gawo. Zotsatira za kafukufukuyu zikuwonetsa kuti anthu ambiri omwe amamwa mankhwalawo anali ndi zotsatirazi:

1. Flatulence, kudzimbidwa, nthawi zina - pachimake kapamba.
2. Urticaria, pruritus, alopecia (kutaya tsitsi), angioedema, zotupa za maculopapular.
3. Kutopa chifukwa cha kusanza, kuwonda osafunikira.
4. Kutopa, kusowa kapena kusokoneza kukoma.
5. Kuwonongeka kwa impso, kukwezeka kwa creatinine, kulephera kwa aimpso kapena kukula kwake.
6. Nthawi zina anaphylactic zimachitika.

Ponena za fanizo lomwe lili ndi zinthu zomwezi, sizipezeka. Mumsika wamankhwala ku Russia, mutha kupeza mankhwala omwe ali ndi vutoli. Izi zikuphatikizapo ma incretin mimetics - Viktoza ndi Januvius. Zambiri zokhudzana ndi izi zimapezeka pa intaneti kapena funsani dokotala.

Ndipo, choncho, exenatide, yomwe imapangidwa pokonzekera Bayeta, imachepetsa shuga m'magazi ndipo siziwatsogolera ku hypoglycemia. Dokotala amamulembera mankhwalawa, kuthetsa zomwe zingachitike contraindication, kusintha kosiyana ndi kuganizira zomwe wodwalayo ali nazo. Kugwiritsa ntchito mankhwalawa molondola, mutha kuchotsa zizindikiritso za shuga kwa nthawi yayitali. Khalani athanzi!

Kuti mukwaniritse chipukuta mokhazikika, chithandizo cha matenda a shuga a 2 chiyenera kukhala chokwanira. Momwe mungachiritsire matenda auzeni katswiri muvidiyoyi.

Baeta | Anafotokozereni Russian mankhwala ndi mitengo ndi ndemanga

Matenda a shuga ndi matenda omwe amasintha kwambiri moyo wa munthu. Chifukwa cha izi, muyenera kutsatira zakudya mosamalitsa ndi masewera olimbitsa thupi, koma zimachitika kuti izi sizokwanira. Zikatero, pamafunika thandizo lachipatala. Baeta ndi mankhwala opangidwa kuti azisintha magazi.

Kugwiritsa

Baeta - mankhwala omwe amachita hypoglycemic effect. Muli yogwira mankhwala exenatide, omwe amapangidwa. Ndi iyo, kuchepa kwamphamvu kwa glucose m'magazi a magazi kumachitika.

Baeta imalimbikitsa kuyambitsa kwa GLP-1 (izi zimachitika ndi yogwira mankhwala exenatide, yomwe ndi incretin mimetic). Mankhwala amalola masoka a pancreatic beta kuti achulukitse kupanga kwa insulin.

Ngati wodwala akudwala hyperglycemia, ndiye kuti Byeta amachepetsa kubisalira kwa glucagon. Ndikofunika kuti mankhwalawa asakhudze mayankho a glucagon. Byeta amachepetsa kuchuluka kwa zomwe zimatuluka m'matumbo.

Izi zimachepetsa chilimbikitso ndi kulemera kwa wodwalayo.

Mankhwalawa angagwiritsidwe ntchito molumikizana ndi mankhwala a metformin ndi insulin. Mothandizidwa ndi izi, kuchuluka kwa shuga m'magazi kumachepetsedwa mwa odwala ndipo ndikotheka kukwaniritsa mulingo woyenera wa glycemic control.

Malangizowo akuwonetsa zotsatirazi pakugwiritsa ntchito mankhwalawa mtundu wa matenda a shuga 2:

• Kwa monotherapy, yogwiritsidwa ntchito ngati chowonjezera pa zochitika zolimbitsa thupi ndi chithandizo cha zakudya.
• Kuphatikiza mankhwala ndi mankhwala omwe ali ndi algorithm ofanana, insulin ndi metformin. Amagwiritsidwa ntchito ngati monotherapy sikubweretsa zotsatira zoyenera.

Mankhwalawa amalowetsedwa pakhungu, pambuyo pake zinthu zodziwikiratu zimamwa kwambiri mwachangu. Kuchuluka kwa mankhwalawa kumatheka patatha maola angapo mutakhazikitsa.

Chithandizo chogwira ntchito chimapangidwa ndi impso zokha. Kutha komaliza hafu ya moyo ndi pafupifupi maola awiri.

Mtundu, jenda, komanso zaka (zokhala ndi impso pazokwanira) zilibe phindu pa mankhwalawa.

Kafukufuku yemwe angadziwe kuvulaza kwa mankhwalawa panthawi yomwe ali ndi pakati komanso mkaka wa m`mawere sanachitike. Nthawi imeneyi, insulin kapena Baeta analogues amagwiritsidwa ntchito nthawi zambiri.

Kafukufuku wokhudza kugwiritsa ntchito mankhwalawa kwa ana osakwana zaka 18 sanachitike. Zikatero, insulin kapena mankhwala ena omwe ali ndi algorithm yofananira amagwiritsidwa ntchito.

Zotsatira zoyipa

Ganizirani zovuta zomwe zingachitike mukamagwiritsa ntchito mankhwalawa:

• Matumbo. Kuchepa kwa chakudya, mavuto ndi chimbudzi, kusanza, kutulutsa m'mimba, mpweya wambiri m'matumbo, kapamba.
• Kupenda. Ngati mumagwiritsa ntchito mankhwalawa monga gawo la mankhwala osakanikirana ndi insulin kapena metformin, ndiye kuti hypoglycemia imatha kuchitika.
• Pakati mantha dongosolo. Kugwedeza zala, kumva kufooka komanso kugona kwambiri.
• Matenda oyambitsidwa ndi malo a jakisoni. Kuphatikiza zotupa ndi kutupa.
• Kulephera kwina.

Ngati mumagwiritsa ntchito mankhwalawa kwa nthawi yayitali, ndiye kuti ma antibodies kwa iye ndiwotheka. Izi zimapangitsa chithandizo china kukhala chopanda ntchito. Ndikofunikira kusiya mankhwalawo, ndikusinthanitsa ndi ofanana, ma antibodies amapita.

Baeta ilibe mankhwala. Chithandizo cha zoyipa zimatengera zisonyezo.

Mtengo wake umatengera mlingo:

• Kuti mupeze yankho la 1.2 ml muyenera kulipira ruble 3990.
• Kuti mupeze yankho la 2.4 ml - 7890 rubles.

M'mayiko osiyanasiyana, mtengo umasinthasintha. Chifukwa, mwachitsanzo, yankho la 1.2 ml linapezeka ma ruble 5590, ndi 2.4 ml - 8570 rubles.

Ganizirani zofanana ndi Bayeta:

• Avandamet. Muli zinthu zosakaniza metformin ndi rosiglitazone, zomwe zimathandizana. Mankhwala amathandizira kuwongolera kuchuluka kwa shuga m'magazi a magazi, kukulitsa chidwi cha maselo a pancreatic beta kupita ku insulin. Itha kugulidwa ma ruble 2400.
• Arfazetin. Ili ndi vuto la hypoglycemic. Zimathandizira kuchepetsa shuga m'magazi. Itha kugwiritsidwa ntchito pothandizira othandizira, koma sioyenera kulandira chithandizo choyenera. Mankhwalawa alibe zotsatira zoyipa ndipo amapitilira kufanana kwake pamtengo. Mtengo - ma ruble 81.
• Bagomet. Muli zinthu zothandiza glibenclamide ndi metformin.Zimawonjezera kukhudzika kwa minofu ku insulin. Amachepetsa cholesterol. Mankhwalawa amathandizanso kutulutsa insulin. Itha kugulika ma ruble 332.
• Betanase Mankhwalawa ndi wothandizira, kuyang'anira magazi nthawi zonse ndikofunikira. Mankhwala contraindicated mu mimba ndi mkaka wa m`mawere. Saloledwa kumwa mowa ndi mankhwala omwe amakhala ndi ethanol panthawi yamankhwala. Ndizovuta kupeza mumafakisi.
• Victoza. Mankhwala okwera mtengo komanso ogwira mtima. Muli yogwira liraglutide. Woperewera amawonjezera insulin, koma osati glucagon. Liraglutide amachepetsa chilolezo cha wodwalayo. Kugulitsidwa mu syringe. Mtengo - 9500 rub.
• Glibenclamide. Muli yogwira mankhwala glibenclamide. Imawonjezera mphamvu ya insulin pa kutenga shuga kudzera minofu. Mankhwalawa ali ndi chiopsezo chochepa cha kukhala ndi hypoglycemia. Itha kugwiritsidwa ntchito ngati gawo la mankhwala ophatikiza. Kugulitsidwa ma ruble a 103.
• Glibomet. Muli ndi metformin. Chimalimbikitsa kuteteza insulin. Itha kugwiritsidwa ntchito ndi insulin. Mankhwala amalimbikitsa kulumikizana kwa insulin ndi ma receptors, alibe chiopsezo chokhala ndi hypoglycemia. Mtengo - 352 rub.
• Gliclazide. Zomwe zimagwiritsidwa ntchito ndi gliclazide. Zimakupatsani mwayi kusintha mulingo wa shuga m'magazi oyenda. Amachepetsa mwayi wamankhwala othamanga, omwe ndi abwino kwa odwala. Mtengo - ma ruble 150.
• Metformin. Amapondera gluconeogenesis. Mankhwalawa samathandizira kubisalira kwa insulin, koma amasintha kuchuluka kwake. Imalola maselo a minofu kuti azitha kuyamwa glucose. Mtengo - 231 rub.
• Januvius. Muli sitagliptin. Ntchito monotherapy kapena mankhwala ophatikiza. Kuchulukitsa kaphatikizidwe ka insulin, komanso kumverera kwa maselo a pancreatic kwa iwo. Mtengo - 1594 rub.

Kodi njira yabwino yogwiritsira ntchito kuchokera pamitundu yonseyi ndi iti? Zimatengera kuwunika kwa wodwala. Saloledwa kusintha kuchokera ku mankhwala amtundu wina kupita nokha, musanagwiritse ntchito ndikofunikira kufunsa katswiri.

Ganizirani ndemanga zomwe anthu amasiya ponena za mankhwala a Bayeta:

Galina alemba (//med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) kuti mankhwalawo sanamuyenerere konse: kudumpha kwa shuga ndi jakisoni ndikosavomerezeka. Mkaziyo adangosintha mankhwalawo, pambuyo pake mkhalidwe wake wabwinanso. Amalemba kuti chinthu chachikulu ndikusunga chakudya.

Dmitry akuti (// med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) kuti wakhala akugwiritsa ntchito mankhwalawa kwa chaka chathunthu. Shuga amasungidwa pamlingo wabwino, koma chinthu chachikulu, malinga ndi mwamunayo, kuchepa kwa thupi ndi 28 kg. Zotsatira zoyipa, zimabweretsa mseru. Dmitry akuti awa ndi mankhwala abwino.

Konstantin akuti (//med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) kuti mankhwalawa ndiabwino, koma majekeseniwo salekerera bwino. Akuyembekeza kuti apeza analogue ya mankhwalawa, omwe akupezeka mufomu ya piritsi.

Ma ndemanga akuti mankhwalawa sathandiza aliyense. Chimodzi mwa zovuta zake zazikulu ndi mtundu wa kumasulidwa. Izi sizabwino kwa odwala onse.

Baeta - mankhwala omwe amakupatsani mwayi kusintha shuga mumagazi. Ndiokwera mtengo kwambiri, koma nthawi zina amaulembera zipatala zaulere. Ngati mutchera khutu kuwunika kwa wodwala, mankhwalawo ali kutali ndi konsekonse.

Sungani kapena gawani:

Zokhudza mankhwalawa

Mankhwala a Baeta amapangidwa ndi kampani yotchuka ku UK. Zimakhala zotsutsana ndi glucagon-peptide, pokhala analogue of insretin. Kuchulukitsa kwa mankhwalawa kumachitika chifukwa cha kuchuluka kwa maselo a beta, monga yankho la chakudya cholowetsedwa ndi shuga m'thupi. Mukatha kudya, Baeta imatchinga kutembenuka kwa glucagon ndikutulutsa kwake kupita kuzowonjezera.

Yogwira popezeka mankhwala zikuchitika pa odwala matenda ashuga m'njira ophatikizika:

• ndi hyperglycemia, amachepetsa kuchuluka kwa shuga m'magazi,
• sangalitsani kapamba,
• sungani mahomoni ngati insulin,
• kuchepetsa thupi
• chepetsa njala,
• incretin, pakukwaniritsa zofunikira za glucose - imatha,
• cholowetsedwa mthupi la wodwalayo ndi jakisoni wofikira,
• chololedwa kugwiritsidwa ntchito ndi anthu omwe ali ndi mtundu umodzi wamatenda,
• Imawerengedwa kuti ndi yolimba komanso yogwira mtima ya insulin (imasiyana ndi mahomoni mu kapangidwe kake ndi kapangidwe ka mankhwala).

Mankhwala amagwiritsidwa ntchito ngati monotherapy, komanso mu ophatikizana a hypoglycemic mankhwala am'deralo. Anapangidwa opangidwa ndi insulin sathandizira shuga, kuletsa kudzikundikira kwake m'mitsempha yamagazi, ziwalo ndi minofu. Mankhwala ochizira matenda a shuga amatchuka kwambiri pakati pa odwala pazifukwa zingapo.

The achire zotsatira ndi chifukwa subcutaneous makonzedwe a mankhwalawa, chifukwa pali mayamwidwe athunthu a zigawo zikuluzikulu, ndipo patapita maola angapo msinkhu shuga amabwerera mwakale. Zotsatira zake zimapitilira ndipo zimakhalapo tsiku limodzi. Amayamwa kuchokera mkodzo ndi mkodzo osasintha mkodzo wamkati.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa wothandizila wodwala matenda ashuga ndi cholembera ndi cholembera chosavomerezeka. Zimatengera njira ya m'badwo watsopano. Amagwiritsidwa ntchito kupangira mahomoni incretin subcutaneously (singano za jekeseni siziphatikizidwa). Njira yothetsera Baeta yopanda utoto ilibe fungo lililonse.

Gawo lomwe limagwiritsa ntchito mankhwalawa ndi Exenatide pa ndende ya 250 mg. Izi zimayikidwa padera pa buluzi, kupatula komwe kumakhalapo chifukwa chosowa zakudya m'thupi.

Panthawi yanjala yokakamiza, zikondamoyo za chonde zimapanga insulin kwambiri. Kutengera chodabwitsa ichi, zotsatira za exenatide pazomwe zili ndi matenda ashuga zakhazikitsidwa.

Kuphatikiza pazomwe zimagwiritsidwa ntchito, zinthu zothandizira zimapezekanso pakupezeka kwa mankhwalawa:

Shuga wamagazi nthawi zonse amakhala 3,8 mmol / L

Momwe mungasungire shuga kukhala wabwinobwino mu 2019

• acetic acid (glacial),
• mannitol
• madzi
• sodium trihydrate mu mawonekedwe a acetate,
• metacresol.

Kuphatikizika kwa mankhwala othandiza komanso magwiridwe antchitowo kumawonjezera mphamvu ya mankhwalawo, kulola odwala matenda ashuga kukhala ndi moyo wabwinobwino.

Malangizo apadera

Mankhwalawa amagwiritsidwa ntchito pofuna kuchiza matenda a shuga a mtundu wachiwiri. Sayenera kuloledwa kugwiritsa ntchito Byet odwala omwe ali ndi vuto la matenda ashuga 1, komanso ngati matendawa akuchuluka komanso kudalira mphamvu ya ma pancreatic.

Byeta siimalo mothandizidwa ndi insulin. Amagwiritsidwa ntchito mu matenda ashuga osagwiritsidwa ntchito pochiza Metformin. Palibe mankhwala omwe amaperekedwa mukamasintha mtundu wina wa insulin kupita ku wina.

Pochiza matenda a shuga kunyumba, akatswiri akulangizani DiaLife. Ichi ndi chida chapadera:

• Amasinthasintha shuga
• Amayang'anira ntchito ya pancreatic
• Chotsani puffness, limayendetsa madzi kagayidwe
• Amawongolera masomphenya
• Zoyenera akulu ndi ana.
• Alibe zotsutsana

Opanga alandila ziphaso zonse zofunika ndi ziphaso za mbiri ku Russia komanso m'maiko oyandikana.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Gulani pa tsamba lovomerezeka

Odwala amatenga lingaliro la kuchepa thupi chifukwa cha kuchepa kwa kudya. Kuyeza kwa magawo amwazi kumachitika tsiku ndi tsiku, kuti musaphonye kuchepa kwa ndende ya glucose pansipa zovomerezeka.

Ndikofunikira pakudya ndi Exenatide ndikukhalabe ndi moyo wogwira ntchito.

Kuphatikiza ndi mankhwala ena

Monga gawo la zovuta mankhwala, mankhwala ochepetsa shuga amathandizidwa mosamala, chifukwa amakhudzanso mankhwala a magulu ena a pharmacological:

• ndi mankhwala a antihypertensive (Lisinopril), nthawi yomwe pakati pa mapiritsi ndi kayendetsedwe ka Bayet iyenera kuonedwa,
• mogwirizana ndi warfarin kumawonjezera nthawi yochotsa hypoglycemic wothandizira,
• mukamagwiritsa ntchito Lonastatin yotsitsa mafuta m'thupi, mphamvu ya exenatide imafooka,
• Hypoglycemic mkamwa othandizira amalimbikitsa mphamvu ya exenatide, yomwe imakhudza kuchepa kwa shuga m'magazi,
• ndi sedative glycoside digoxin, mphamvu ya othandizira onse amachepa, ndipo nthawi yowonjezera ikuwonjezeka.

Mapiritsi ndi makapisozi okhala ndi mafilimu, zotupa zadzidzidzi zomwe zimachitika m'matumbo am'mimba, ziyenera kutengedwa asanakonzekere a Baeta. Kupanga dyspeptic syndrome kumakhudza kwambiri pharmacodynamics ya mankhwala ndi mkhalidwe wamatumbo.

Baeta: malangizo ogwiritsira ntchito, mtengo, ndemanga, analogi

Matenda a shuga ndi matenda omwe amasintha kwambiri moyo wa munthu. Chifukwa cha izi, muyenera kutsatira zakudya mosamalitsa ndi masewera olimbitsa thupi, koma zimachitika kuti izi sizokwanira. Zikatero, pamafunika thandizo lachipatala. Baeta ndi mankhwala opangidwa kuti azisintha magazi.

Zogwira pophika: zimakhala ndi exenatide 250 mcg.

Omwe amathandizira: sodium acetate trihydrate, glacial acetic acid, mannitol, metacresol, madzi d / i.

Zizindikiro Bayeta

Monotherapy: Type 2 shuga mellitus ngati monotherapy kuwonjezera pa zakudya ndi masewera olimbitsa thupi kuti mukwaniritse bwino glycemic control.

Type 2 shuga mellitus ngati mankhwala owonjezera ngati mulephera kukwaniritsa bwino glycemic control:

• Metformin, woyambira sulfonylurea, thiazolidinedione.
• Kuphatikiza kwa metformin ndi zotumphukira za sulfonylurea.
• Metformin ndi thiazoldinedione.

Contraindication Bayeta

Mtundu woyamba wa matenda a shuga kapena kupezeka kwa matenda ashuga a ketoacidosis. Kulephera kwambiri kwaimpso (kulengedwa kwa creatinine kosakwana 30 ml / min). Kupezeka kwa matenda am'mimba kwambiri ndi concomitant gastroparesis. Mimba

Kuchepetsa (kuyamwitsa). Ana ochepera zaka 18 (chitetezo ndi mphamvu ya mankhwalawa mu ana sanakhazikitsidwe).

Hypersensitivity kuti exenatide kapena excipients omwe amapanga mankhwalawa.

Malangizo ogwiritsira ntchito

Mankhwalawa amaperekedwa pa ntchafu, pamimba kapena pamphumi. Mlingo woyamba ndi 5 mcg, womwe umaperekedwa kawiri pa tsiku nthawi iliyonse kwa mphindi 60 musanadye chakudya cham'mawa ndi chamadzulo. Musamwe mankhwala mukatha kudya.

Ngati jakisoni wa mankhwalawo akusowa, chithandizo chimapitilira osasintha mlingo. Patatha mwezi umodzi chiyambire chithandizo, mlingo wa mankhwalawa ukhoza kuchuluka mpaka 10 mcg 2 pa tsiku.

Kuphatikizidwa ndi metformin, thiazolidinedione, kapena kuphatikiza kwa mankhwalawa, mlingo woyambirira wa metformin ndi / kapena thiazolidinedione sungasinthidwe.

Pankhani ya kuphatikiza kwa Bayeta ® ndi zotumphukira zochokera ku sulfonylurea, njira yochepetsera kupezeka kwa sulfonylurea ingafunike kuti muchepetse chiopsezo cha hypoglycemia. Gwiritsani ntchito ntchito yolakwika yaimpso

Mankhwala ndi contraindicated mu kwambiri aimpso kulephera (kulengedwa kwa creatinine zosakwana 30 ml / min).

Zotsatira zoyipa za Baeta

Zotsatira zoyipa zomwe zidachitika nthawi zambiri kuposa zomwe zimachitika padera zimalembedwa molingana ndi izi: pang'onopang'ono - ,10%, nthawi zambiri - ≥1%, koma

Kuchokera mmimba dongosolo: pafupipafupi - nseru, kusanza, kutsegula m'mimba, pafupipafupi - kusowa kwa chilimbikitso, kukomoka, kupweteka kwam'mimba, kutulutsa, kupweteka, kudzimbidwa, kuphwanya masinthidwe akumva kukoma, kusangalala.

Kuchokera kumbali ya dongosolo lamkati lamanjenje: Nthawi zambiri - chizungulire, kupweteka mutu, kawirikawiri - kugona.

Kuchokera ku dongosolo la endocrine: nthawi zambiri - hypoglycemia (kuphatikiza ndi zotumphukira za sulfonylurea), nthawi zambiri - kumanjenjemera, kufooka, hyperhidrosis.

Thupi lawo siligwirizana: kawirikawiri - zidzolo, kuyabwa, angioedema, osowa - anaphylactic reaction.

Zina: nthawi zambiri - zimachitika pakhungu jakisoni jekeseni, osowa - madzi m'thupi (ogwirizana ndi mseru, kusanza komanso / kapena kutsegula m'mimba). Zochulukitsa zingapo za nthawi yowonjezera magazi (INR) imanenedwa ndi kugwiritsidwa ntchito nthawi imodzi kwa warfarin ndi exenatide, yomwe nthawi zina imayenderana ndi magazi.

Chifukwa chakuti pafupipafupi hypoglycemia imachulukana ndi mgwirizano wa mankhwala a Baeta okhala ndi zotumphukira za sulfonylurea, ndikofunikira kulingalira kuchepetsa kuchuluka kwa zotuluka za sulfonylurea ndi chiopsezo chowonjezeka cha hypoglycemia. Magawo ambiri a hypoglycemia mwamphamvu anali ofatsa kapena olimbitsa ndipo anali kuyimitsidwa ndi kudya kwa pakamwa.

Mwambiri, zotsatilapo zake zinali zochepa kapena zolimbitsa kwambiri ndipo sizinachititse kuchoka pakulandila chithandizo. Nthawi zambiri, kunyodola kwamphamvu kofatsa kapena kolimbitsa thupi kumadalira mlingo ndipo kumachepetsa pakapita nthawi, osasokoneza zochita za tsiku ndi tsiku.

Simalimbikitsidwa pakamwa / mu kapena mu m.

Bayeta® sayenera kugwiritsidwa ntchito ngati tinthu tating'onoting'ono tapezeka mu yankho kapena ngati njirayo ili ndi mitambo kapena ngati ili ndi banga.

Ma antibodies kuti atulutse thupi amatha kuoneka pa nthawi ya mankhwala ndi Bayeta®. Komabe, izi sizikhudza pafupipafupi komanso mitundu yazotsatira zoyipa zomwe zaperekedwa.

Odwala ayenera kudziwitsidwa kuti kulandira chithandizo ndi Bayeta® kungayambitse kuchepa kwa chilimbikitso ndi / kapena kulemera kwa thupi komanso kuti chifukwa cha izi palibe chifukwa chosinthira njira.

Odwala asanayambe chithandizo ndi Bayeta® ayenera kudziwa bwino Chitsogozo chogwiritsa ntchito cholembera chomwe chimaphatikizidwa ndi mankhwalawo.

Zotsatira za maphunziro oyesera

M'maphunziro oyesa mbewa ndi makoswe, palibe zotsatira zowononga thupi za exenatide. Makoswe atapatsidwa mlingo wa mankhwalidwe a 128 mwa anthu, kuchuluka kwa ma cell a C-cell adenomas kunadziwika popanda zisonyezo zilizonse, zomwe zimakhudzana ndi kuwonjezeka kwa nthawi yayitali ya nyama yoyesera yomwe ilandila exenatide.

Zizindikiro: kunyansidwa kwambiri komanso kusanza, komanso kukula msanga kwa hypoglycemia (mukamamwa mlingo kakhumi mopitilira pazomwe mwalimbikitsa).

Chithandizo: symptomatic mankhwala ikuchitika, kuphatikiza matenda a glucose makamaka hypoglycemia.

Bayeta® iyenera kugwiritsidwa ntchito mosamala odwala omwe amamwa mankhwala pakamwa omwe amafunikira kuti atuluke msanga m'matumbo, chifukwa Byeta® imachedwa kutaya.

Odwala ayenera kulangizidwa kuti amwe mankhwala amkamwa, momwe zimadalira mphamvu zawo (mwachitsanzo, mankhwala a antibayotiki), osachepera ola limodzi musanayambitse exenatide.

Ngati mankhwalawa amayenera kumwa ndi chakudya, ndiye kuti ayenera kumwedwa nthawi yomwe chakudya sichikuperekedwa.

Ndi makonzedwe omwewo a digoxin (pa mlingo wa 0,25 mg 1 nthawi / tsiku) pokonzekera Bayeta®, max ya digoxin amatsika ndi 17%, ndipo T max imawonjezeka ndi maola 2,5.

Ndi kukhazikitsidwa kwa Bayeta®, AUC ndi Cmax ya lovastatin kutsika ndi pafupifupi 40 ndi 28%, motero, ndipo Tmax idakulirakulira pafupifupi maola 4. Kugwirizana-kuyang'anira Bayeta® ndi HMG-CoA reductase inhibitors sikunayendetsedwe ndi kusintha kwa kapangidwe ka magazi lipid (cholesterol ya HDL, LDL cholesterol, cholesterol yathunthu ndi triglycerides).

Odwala omwe ali ndi vuto lochepa kwambiri kapena lozama la okhazikika mwa osinopril (5- 20 mg / tsiku), Bayeta® sinasinthe AUC ndi Cmax ya lisinopril pakufanana. Tmax of lisinopril pa equilibrium idakwera ndi maola 2. Panalibe zosintha pazomwe zikusonyeza pakati pa SBP ndi DBP tsiku lililonse.

Zidadziwika kuti ndikuyambitsa kwa warfarin mphindi 30 pambuyo pakukonzekera kwa Bayeta® Tmax kumawonjezeka pafupifupi maola 2. Palibe kusintha kwakukuru mu Cmax ndi AUC komwe kunawonedwa. Kugwiritsa ntchito Bayeta® kuphatikiza ndi insulin, D-phenylalanine, zotumphukira za meglitinides kapena alpha-glucosidase sizinaphunzire.

Sungani 2 mpaka 8 ° C. Moyo wa alumali: zaka ziwiri.

Analogs popanga ndi chisonyezo chogwiritsidwa ntchito

Mndandanda womwe uli pamwambapa wa analogies ya mankhwala, omwe akuwonetsa Zowonjezera za Baeta, ndizabwino kwambiri chifukwa zimakhala ndi zinthu zomwe zimagwirizana ndipo zimagwirana molingana ndi chisonyezo chogwiritsidwa ntchito

Analogs mwa chisonyezo ndi njira yogwiritsira ntchito

Kuphatikizika kosiyanasiyana, kungagwirizane mukuwonetsa ndikugwiritsa ntchito njira

Kodi mungapeze bwanji analogue yotsika mtengo ya mankhwala okwera mtengo?

Kuti mupeze chiwonetsero chotsika mtengo cha mankhwala, chofananira kapena chofanana, choyambirira timalimbikitsa kulabadira kapangidwe kake, zomwe ndi zinthu zomwezo zomwe zikugwira komanso zomwe zikugwiritsidwa ntchito. Zomwe zimagwiritsidwanso mosiyanasiyana ndi mankhwalawa zimawonetsa kuti mankhwalawo ndi ofanana ndi mankhwalawo, monga mankhwala ena kapena mitundu ina. Komabe, musaiwale za zovuta zomwe zimagwiritsidwa ntchito ndi mankhwala ofanana, omwe angakhudze chitetezo ndi kugwiranso ntchito. Musaiwale za malangizo a madotolo, kudzipereka nokha kungawononge thanzi lanu, chifukwa chake onani dokotala wanu musanagwiritse ntchito mankhwala.

Glibenclamide

4 imapereka kuyambira 100.00 kale 135.00 opaka

4 imapereka kuyambira 112.00 kale 126.00 opaka

19 imapereka kuyambira 339.00 kale 615.00 opaka

34 amapereka akuyamba kuyambira 55.00 kale 11,650.00 opaka

27 imapereka kuyambira 48.00 kale 178.00 opaka

2 imapereka kuyambira 227.00 kale 246.00 opaka

Glimepiride Mankhwala

1 kupereka kuyambira 180.00 kale 180.00 opaka

13 imapereka kuyambira 147.00 kale 376.00 opaka

18 imapereka kuyambira 290.00 kale 436.00 opaka

29 imapereka kuyambira 154.00 kale 805.00 opaka

11 imapereka kuyambira 97.00 kale 345.00 opaka

45 imapereka kuyambira 1,250.00 kale 4,044.00 opaka

Kutalika kwa Combogliz

18 imapereka kuyambira 3,090.00 kale 3,899.00 opaka

10 imapereka kuyambira 1,425.00 kale 1,959.00 opaka

17 imapereka kuyambira 1,469.00 kale 1,767.00 opaka

63 imapereka kuyambira 667.00 kale 1,904.00 opaka

19 imapereka kuyambira 1,749.00 kale 2,189.00 opaka

25 imapereka kuyambira 689.00 kale 1,369.00 opaka

16 amapereka kuyambira 1,648.00 kale 1,959.00 opaka

Zofananira zonse za Baeta zimaperekedwa pazachidziwitso chokha ndipo sikuti ndi chifukwa chodziyimira payokha pakubwezera mankhwala. Musanagwiritse ntchito mankhwalawa, funsani dokotala wanu ndikuwerengera momwe mungagwiritsire ntchito.

KULIMBITSA KWAULERE KUNGAKHALITSE MOYO Wanu

Hypoglycemic mankhwala Baeta: Malangizo ntchito, mtengo, ndemanga ndi analogi

Baeta ndimakonzedwe opangidwa kutengera zinthu exenatide, zomwe zimakhala ndi hypoglycemic.

Izi zimadziwika mwa kuyambitsa glucagon-ngati peptide-1 zolandilira ndikulimbikitsa kapangidwe ka insulin ya ma cell ndi beta-maselo a pancreatic gland, omwe amathandiza kutsitsa shuga.

Zina mwazithandizo za Beat ndizo:

• kutsitsa shuga wamagazi ndikuletsa kukula kwa zizindikiro za hyperglycemia,
• kuchepa kwa kupukusa kwamphamvu kwa glucagon poyankha hyperglycemia kwa odwala omwe ali ndi matenda a shuga a 2,
• Kuchepetsa kuchepa kwa zinthu zam'mimba komanso kuthana ndi njala.

Mankhwala Beata akuwonetsedwa kuti amagwiritsidwa ntchito kokha kwa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri. Amasankhidwa kuti azilamulira kuchuluka kwa glycemia mwa odwala omwe amalandila chithandizo chodwala matenda a shuga a sulfonylurea and metformin.

Zolemba zogwiritsira ntchito

Mankhwalawa amathandizidwa ndi mankhwalawa kumtunda kapena pakatikati pa phewa, ntchafu, komanso m'mimba. Monga lamulo, tikulimbikitsidwa kusinthana mawebusayiti kuti tipewe kupangika kwa ma memblomerates a subcutaneous.

Kubaya kuyenera kuchitidwa mogwirizana ndi malamulo onse ogwiritsira ntchito cholembera. Mankhwala ayenera kuperekedwa kwa ola limodzi pamaso waukulu chakudya pafupipafupi 6 maola.

Exenatide sangathe kusakanikirana ndi mitundu ina ya mlingo, yomwe ingapewe kukula kosakhudzidwa kosayenera.

Dokotala yekha ndi amene ayenera kumwa mankhwalawa, monga momwe shuga wina amathandizira, kuchuluka kwa mankhwala akuluakulu a hypoglycemic, kupezeka kwa zovuta zina, ndi zina zotero.

Nthawi zambiri mlingo woyambirira wa Baeta ndi 5 mcg kawiri pa tsiku kwa milungu inayi.

Kupitilira apo, kuchuluka kwa zinthu zomwe zimayendetsedwa zimatha kuwonjezeka mpaka 10 μg patsiku (ngati kuli koyenera). Sitikulimbikitsidwa kupitilira muyeso wa oposa 10 mcg.

Zizindikiro za mankhwala osokoneza bongo amapezeka kuti amagwiritsidwa ntchito zoposa 100 μg ya chinthu patsiku ndipo akuwoneka ngati kusanza kwambiri motsutsana ndi maziko a hypoglycemia yomwe ikupita patsogolo.

Exenatide: mtengo ndi fanizo la Bayeta

Mankhwala Baeta, omwe mankhwala ake ndi exenatide, amaonedwa ngati mankhwala apadera a hypoglycemic. Chida chimagwiritsidwa ntchito pochiza matenda a shuga a 2, makamaka olemedwa ndi kunenepa kwambiri.

Kugwiritsa ntchito bwino kwa mankhwalawa kumagwirizanitsidwa ndi kapangidwe ka chinthu chofunikira kwambiri, chomwe chimachepetsa kuchuluka kwa shuga m'magazi.

Zimawonjezera katulutsidwe ka insulin, komanso, zolimbikitsa ma insretin, zimakhala ndi zotsitsimutsa zina:

• imathandizira kugwira ntchito kwa maselo a pancreatic beta, omwe amachititsa kuti insulin ipange,
• amachepetsa katulutsidwe wa glucagon, kamene kamapangitsa shuga m'magazi,
• Imachepetsa kumasula.

Ubwino wambiri wa chinthu monga exenatide ndikuti umachulukitsa kupanga insulini kuchokera parenchyma, kenako ndikuyimitsa katulutsidwe wake pamene magazi a shuga abwerera mwachizolowezi.

Chifukwa chake, kuthekera kwa kuyambika kwa vuto la hypoglycemic mwa anthu kuli pafupifupi zero.

Thupi likalowa m'thupi la munthu, nthawi yomweyo limayamba kugwira ntchito ndikufika pachimake mu maola awiri. Kutalika kwa exenatide ndi maola 24, kotero kuyambitsa kwake kamodzi patsiku kumapereka kuchepa kwa kuchuluka kwa shuga nthawi yomweyo.

Kuphatikiza apo, exenatide amachepetsa chidwi cha anthu odwala matenda ashuga, chifukwa, amadya chakudya chochepa, kusunthika kwa m'mimba kumachepetsa, ndipo sikutha msanga mwachangu.

Chifukwa chake, zinthu zotere sizimangoyendetsa shuga wamagazi, komanso zimathandizira kuchotsa ma kilogalamu 4-5.

Exenatide 2 mg

Dongosolo kuchokera kuperekera mu firiji yapamwamba ku Moscow kapena Russia. Malipiro - ndalama pakubweza! Mtengo wawonetsedwa pamwambapa. Pamalonda! Zomwe zikuphatikizidwa ndi malangizo ogwiritsira ntchito komanso chikalata chaumboni kuchokera kwa wopanga.

Malonda athu amapangidwa mogwirizana ndi zofunikira za European GMP EU ndi malamulo a Germany Gawo 13 AMG kutsimikizira mtundu ndi chitetezo cha mankhwalawo.

Yavomerezedwa ndi American FDA ndi European Medical Agency.

Malangizo a Exenatide

Malongosoledwewa ali pamalangizo ogwiritsira ntchito, kuwunika kwa odwala ndi zotsatira za mayeso azachipatala.

Bidureon ndi mankhwala operekera shuga m'magazi achikulire odwala matenda a shuga a 2. Iyenera kugwiritsidwa ntchito limodzi ndi zakudya komanso masewera olimbitsa thupi, komanso mankhwala aliwonse omwe mukumwa pakumwa pano.

Osavomerezeka kuti agwiritsidwe ntchito ngati chithandizo choyambirira cha matenda ashuga.

Mankhwalawa atha:

• amachepetsa kwambiri kuchuluka kwa hemoglobin A1C m'magazi,
• chepetsani kunenepa, koma exenatin si mankhwala ochepetsa thupi!

Maphunziro a Zachipatala Exenatide

Odwala a shuga a Type 2 adatenga nawo gawo pakuwunika kwa mankhwalawa komanso chitetezo cha mankhwalawa. Pambuyo pa maphunziro a masabata a 24 omwe amamwa mankhwala a Bidureon pa 2 mg patsiku:

• kuchuluka kwa shuga m'magazi kunachepetsedwa mpaka 1.6% (pafupifupi koyamba koyamba - 8.5%),
• Kuchepetsa thupi ndi pafupifupi 2.5 kg.

Ndikofunikira kukumbukira kuti mankhwalawa sanapangidwe kuti achepetse thupi!

Njira yamachitidwe

Bidureon ndi mankhwala opitilira pang'onopang'ono. Zochitika limodzi mlingo kumatenga masiku 7. Mankhwalawa amathandiza thupi lanu kumasula insulin yake pakamafunika kuti muchepetse shuga, kukhala otakataka sabata yonse.

Mlingo uliwonse umakhala ndi ma microspheres (tinthu ting'onoting'ono) tomwe timakhala ndi mankhwala othandizira - exenatide,

Tinthu timeneti timawonongeka pang'onopang'ono, pang'onopang'ono kumasula mankhwalawa mthupi lanu patadutsa sabata limodzi kuti muthandizire kuwongolera shuga. Kuphatikiza apo, mukamamwa mankhwalawa, kuchuluka kwa chimbudzi ndi kudya zimachepetsedwa pang'ono, zomwe zimapangitsa kuti muchepetse kulemera pang'ono.

Popeza zimatha kutenga milungu isanu ndi umodzi mpaka isanu ndi iwiri kuti mupeze mulingo woyenera wa mankhwalawa m'magazi, ndikofunikira kupitiliza kumwa mankhwalawa monga adanenera dokotala.

Momwe mungamwe mankhwalawa. Malangizo a sitepe ndi sitepe:

1. chotsani mufiriji ndi ufa umodzi wa mankhwalawo.
2. sambani manja anu bwino
3. ikani singano, thumba cholumikizira, vial ndi syringe pamalo oyera, osalala,
4. tenga singano ndikudula kapu ya buluu
5. tengani botolo, mulikupukute kangapo pamtunda kuti ulimbikitse ufa,
6. gwiritsani chala chanu chaching'ono kuti muchotse cholembera chobiriwira, ikani botolo pambali,
7. tengani chikwama cholumikizira ndikuchotsa chivundikiro (osakhudza cholumikizira cha lalanje mkati,
8. atanyamula chikwama cholumikizira dzanja limodzi, mutenge botolo mbali inayo,
9. kanikizani pamwamba pa valaini yolumikizira yolumikizana yolumikizana, ndikuyinyamula,
10. tengani syringe, ndi dzanja linalo mwamphamvu zigawo 2 zaimvi pazolo loyera,
11. sulani ndikutaya chivundikirocho (samalani kuti musakanize piston),
12. tengani botolo ndi cholumikizira cha lalanje, cholunga cholumikizira ku syringe mpaka chitayima.

Zofunika! Pakadali pano, musakaniza mankhwalawa ndikudzaza syringe. Mukasakaniza mankhwalawa, mupereka jakisoni. Simungathe kusunga mankhwala osakanikirana panthawi ina.

1. kanikiza pisitoni ndi chala chako mpaka chitayima,
2. mukugwira piston pansipa, gwedezani botolo bwino mpaka madzi ndi ufa atasakaniza bwino,
3. legulani botolo kuti syringe ikuloze, pitilizani kugwirizira pisitoni,
4. mokoka pang'onopang'ono botolo mbali inayo
5. kokerani piston kudutsa mzere wakuda womwewo - izi zimasunthira mankhwalawo kuchokera kumtunda kupita ku syringe,
6. ndi dzanja lanu lina, tembenuzani cholumikizira cha lalanje kuti muchotsemo syringe. Samalani kuti musakanize pisitoni,
7. tenga singano ndi kuipukuta pa syringe mpaka itayima, osachotsa chivundikiracho,
8. ponyani pisitoni pang'onopang'ono kuti kumtunda kwa piston kutenthetseke ndi mzere wakuda wakuda womwe ukuonetsa mlingo wofunikira, chotsani chala chanu piston,
9. gwiritsani ntchito jakisoni ndi swab ya mowa,
10. gwira syrinji pamalo omwe pali mzere wakuda,
11. chotsani kansalu pachibowo,
12. ikani singano mu jakisoni wa jakisoni (mosakakamiza) ndi kulowa muyezo wathunthu wa mankhwalawo malinga ndi njira yomwe dokotala wakupatsani.

Kodi muwonetsetse bwanji kuti mankhwalawo amathandizidwa bwino?

Kanikizani pistoniyo mpaka mumve kudina kodziwikiratu. Pambuyo pake, dikirani masekondi ena 10. Tsopano mutha kukhala otsimikiza kuti mudachita zonse bwino

Mukamaitanitsa phukusi zingapo mumapeza kuchotsera:

Mapaketi awiri pa: 400.00 €

Mapaketi atatu pa: 395.00 €

Mapaketi 4 pa: 390.00 €

Phukusi zisanu pa: 385.00 €

Mapaketi 10 pa: 375.00 €

Zotsatira za pharmacological

Hypoglycemic mankhwala. Exenatide (Exendin-4) ndi incretin mimetic ndipo ndi 39-amino acid amidopeptide.

Ma insretins, monga glucagon-peptide-1 (GLP-1), amalimbikitsa kuteteza shuga m'magazi, amasintha ntchito za beta, kupondera kutulutsa shuga mwachangu komanso kuchepetsedwa kwa m'mimba atamaliza kulowa m'magazi ambiri.

Exenatide ndi mphamvu ya insretin mimetic yomwe imathandizira secretion ya glucose yomwe imadalira shuga ndipo imakhala ndi zotsatira zina za hypoglycemic zomwe zimayambira ma incretins, zomwe zimapangitsa kuti glycemic control mu odwala a mtundu wa 2 shuga.

Mndandanda wa amino acid wokhudzana ndi exenatide pang'ono umafanana ndi kufanana kwa anthu a GLP-1, chifukwa chomwe chimamangiriza ndikuyambitsa zolandilira za GLP-1 mwa anthu, zomwe zimapangitsa kuti chiwonetsero cha glucose chikudalira komanso kuteteza insulini kuchokera ku maselo a beta ochulukirapo ndikutenga gawo la cyclic AMP ndi / kapena siginecha yina njira.

Exenatide imathandizira kutulutsa kwa insulin kuchokera ku maselo a beta pamaso pa kutsika kwa glucose. Exenatide amasiyana mu kapangidwe ka mankhwala ndi zochita zamapangidwe a insulin, zotumphukira za sulfonylurea, zotumphukira za D-phenylalanine ndi meglitinides, biguanides, thiazolidinediones ndi alpha-glucosidase inhibitors.

Exenatide imathandizira kuwongolera kwa glycemic mwa odwala omwe ali ndi matenda a shuga a 2 chifukwa cha njira zotsatirazi. M'mikhalidwe ya hyperglycemic, exenatide imakulitsa katulutsidwe wama shuga a insulin kuchokera kuma cell a pancreatic beta.

Kubisirana kwa insulin kumeneku kumatha kutsika kwa magazi a glucose kutsika ndikuyandikira njira yokhazikika, potero kumachepetsa chiopsezo cha hypoglycemia. Kubisalira kwa insulin kwa mphindi 10 zoyambirira (poyankha kuchuluka kwa glycemia), komwe kumatchedwa "gawo loyamba la mayankho a insulin" odwala 2 matenda ashuga.

Kuphatikiza apo, kutayika kwa gawo loyamba la mayankho a insulin ndikusokonezeka koyambirira kwa ntchito ya cell ya beta mu mtundu 2 shuga. Kukhazikitsidwa kwa exenatide kumabwezeretsa kapena kumakulitsa kwambiri magawo oyamba ndi achiwiri a kuyankha kwa insulin odwala omwe ali ndi matenda a shuga a 2.

Odwala ndi mtundu 2 matenda a shuga mellitus motsutsana maziko a hyperglycemia, makonzedwe a exenatide amachepetsa kwambiri secretion wa glucagon. Komabe, exenatide sichimasokoneza mayankho abwinobwino a glucagon ku hypoglycemia. Zinawonetsedwa kuti kukhazikitsa exenatide kumayambitsa kutsika kwa kudya komanso kuchepa kwa chakudya, kumalepheretsa m'mimba, zomwe zimapangitsa kuti ntchito zake zizichira. Odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga a mellitus, exenatide mankhwala osakanikirana ndi metformin, thiazolidinedione ndi / kapena sulfonylurea kukonzekera kumayambitsa kutsika kwa shuga wamagazi, postpandial glucose, komanso HbA1c, potero kuwongolera kayendedwe ka glycemic mwa odwalawa.

Pharmacokinetics

Mafuta Pambuyo pakuyamwa kwa exenatide muyezo wa 10 μg kwa odwala omwe ali ndi matenda a shuga 2, exenatide amatengeka msanga ndikufika pa ma C pambuyo pa maola a 2.1, omwe ndi 211 pg / ml, AUCo-inf ndi 1036 pg? h / ml Mukawonetsedwa ndi exenatide, AUC imawonjezeka molingana ndi kuchuluka kwa mlingo kuchokera pa 5 μg mpaka 10 μg, pomwe palibe kuwonjezeka kwa Cmax.

Zomwezi zimawonedwa ndi subcutaneous makonzedwe a exenatide pamimba, ntchafu kapena dzanja. Kugawa kwa Vd exenatide pambuyo pa utsogoleri wa sc ndi 28.3 L. Metabolism ndi excretion Exenatide makamaka imathandizidwa ndi kusefera kwa glomerular kutsatiridwa ndi kuwonongeka kwa proteinolytic. Chilolezo cha Exenatide ndi 9.1 l / h. T1 / 2 yomaliza ndi maola 2.4.

Izi pharmacokinetic machitidwe a exenatide ndi kumwa palokha. Miyezo yoyeserera ya exenatide imatsimikiziridwa pafupifupi maola 10 mutatha dosing.

Pharmacokinetics mu milandu yapadera yamankhwala Odwala omwe ali ndi vuto lofooka kapena lochepa (CC 30-80 ml / min), chilolezo cha exenatide sichimasiyana kwambiri ndi chilolezo cha odwala omwe ali ndi vuto lofanana laimpso, motero, kusintha kwa mankhwala sikofunikira.

Komabe, mwa odwala omwe ali ndi vuto loti aimpso amatha kudutsa dialysis, chilolezo chochepa chimachepetsedwa kukhala 0,9 l / h (poyerekeza ndi 9.1 l / h m'maphunziro athanzi) Popeza exenatide imagwiritsidwa ntchito makamaka ndi impso, akukhulupirira kuti chiwindi chomwe chimagwira ntchito sichimasinthanso kuchuluka kwa exenatide m'magazi. M'badwo sizikhudza mawonekedwe a pharmacokinetic a exenatide.

Chifukwa chake, odwala okalamba sayenera kuchita kusintha kwa mlingo. Ma pharmacokinetics a exenatide mwa ana osakwana zaka 12 sanaphunzire. Mu kafukufuku wa pharmacokinetic mu achinyamata a zaka 12 mpaka 16 zokhala ndi matenda a shuga 2, pomwe exenatide adalembedwa pa mlingo wa 5 μg, magawo a pharmacokinetic anali ofanana ndi akulu.

Palibe kusiyana kwakanema pakati pa amuna ndi akazi omwe ali mu pharmacokinetics of exenatide. Ma pharmacokinetics a exenatide mwa oyimira mafuko osiyanasiyana samasintha. Kusintha kwa mankhwalawa kutengera mtundu wa makolo sikofunikira. Palibenso kulumikizana kowoneka bwino pakati pa body index index (BMI) ndi exenatide pharmacokinetics. Kusintha kwa Mlingo woyambira BMI sikofunikira.

Mikhalidwe yapadera

Musamwe mankhwala mukatha kudya. Simalimbikitsidwa pakamwa / mu kapena mu m. Bayeta® sayenera kugwiritsidwa ntchito ngati tinthu tating'onoting'ono tapezeka mu yankho kapena ngati njirayo ili ndi mitambo kapena ili ndi utoto.

Chifukwa cha kufooka kwa mankhwala omwe ali ndi mapuloteni ndi ma peptides, kupanga ma antibodies of exenatide kumatha kuchitika panthawi ya mankhwala ndi Bayeta®. Mwa odwala ambiri omwe kupanga mankhwala oterewa amadziwika, mankhwala awo am'mimba atachepa pomwe chithandizo chanapitirira ndikukhala otsika kwa masabata a 82.

Kukhalapo kwa ma antibodies sikumakhudza ma frequency ndi mitundu ya zotsatirapo zoyipa. Odwala ayenera kudziwitsidwa kuti kulandira chithandizo ndi Bayeta® kungayambitse kuchepa kwa chilimbikitso ndi / kapena kulemera kwa thupi, komanso kuti chifukwa cha izi palibe chifukwa chosinthira njira.

M'maphunziro oyesa mbewa ndi makoswe, palibe zotsatira zowononga thupi za exenatide.

Mlingo womwe umagwiritsidwa ntchito mu makoswe omwe anali kuchuluka kwa kuchuluka kwa mankhwalawa 128 mwa anthu, kuchuluka kwa ma cell a C-cell adenomas kunadziwika popanda zisonyezo zilizonse, zomwe zimagwirizanitsidwa ndi kuchuluka kwa chiyembekezo cha nyama zoyesera zomwe zimalandira exenatide.

Nthawi zambiri vuto laimpso limanenedwa, kuphatikizapo kuwonjezeka kwa seramu creatinine, kukula kwa kulephera kwa impso, kukulitsa njira yolephera komanso yovuta yaimpso, ndipo nthawi zina hemodialysis imafunikira.

Zina mwazinthu izi zimawonedwa mwa odwala omwe amalandila mankhwala amodzi kapena zingapo zomwe zimakhudza kugwira ntchito kwa impso / madzi ndi / kapena zina zotsutsana ndi zochitika zina zomwe zimapangitsa kuti magazi asungunuke, monga nseru, kusanza ndi / kapena kutsegula m'mimba. Mankhwala olowa nawo anaphatikiza ACE inhibitors, NSAIDs, komanso okodzetsa.

Mukamapereka mankhwala othandizira ndikuchotsa mankhwalawo, mwina chifukwa cha kusintha kwa matenda, minyewa yaimpso imabwezeretseka. Mukamachita kafukufuku wamakedzana komanso zamankhwala a exenatide, umboni wa nephrotoxicity mwachindunji sunapezeka. Zovuta za pancreatitis zowopsa zimanenedwapo mukutenga Bayeta®. Odwala ayenera kudziwitsidwa za zomwe zimachitika ndi chifuwa chachikulu cha kapamba: kulimba kwam'mimba kwambiri. Mukamapereka mankhwala othandizira, kuyesa kwa pancreatitis pachimake kunawonedwa. Odwala asanayambe chithandizo ndi Bayeta® ayenera kudziwa "Chowongolera chogwiritsa ntchito cholembera 'chophatikizika ndi mankhwalawo.

• 1 ml exenatide 250 mcg Excipients: sodium acetate trihydrate - 1.59 mg, acetic acid - 1.1 mg, mannitol - 43 mg, metacresol - 2.2 mg, madzi d / i - q.s. mpaka 1 ml.

Kuyanjana kwa mankhwala osokoneza bongo

Bayeta® iyenera kugwiritsidwa ntchito mosamala kwa odwala omwe akukonzekera kukamwa kumene amafunika kutuluka mwachangu kuchokera m'mimba, chifukwa Byeta® imachedwa kutaya.

Odwala ayenera kulangizidwa kumwa mankhwala pakamwa, momwe zimatengera mphamvu zawo (mwachitsanzo, mankhwala opha maantibayotiki), osachepera ola limodzi makonzedwe a exenatide. Ngati mankhwalawa amayenera kumwa ndi chakudya, ndiye kuti ayenera kumwedwa nthawi yomwe chakudya sichikuperekedwa.

Ndi makonzedwe omwewo a digoxin (0,25 mg 1 nthawi /) pokonzekera Baeta®, max ya digoxin amatsika ndi 17%, ndipo Tmax imawonjezeka ndi maola 2,5. Komabe, AUC yomwe ili mdziko lofanana sizisintha.

Poyerekeza ndi kuyang'anira kwa Bayeta ®, AUC ndi Cmax ya lovastatin idatsika ndi 40% ndi 28%, motero, Tmax idakulirakulira pafupifupi maola 4. Kugwirizana kwa Bayeta® ndi HMG-CoA reductase inhibitors sikunayendetsedwe ndi kusintha kwa lipid yamagazi.

Bongo

Ngati mankhwala osokoneza bongo mlingo wokwanira 10 mlingo woyenera bwino, zizindikiro zotsatirazi zimachitika: kunyansidwa kwambiri komanso kusanza, komanso kuchepa msanga kwa magazi m'magazi a hypoglycemia. Chithandizo: Zizindikiro, kuphatikizapo iv kukonzanso kwa dextrose yothetsera vuto la hypoglycemia.