Baeta - malangizo ogwiritsidwa ntchito

Fomu ya Mlingo - njira yothetsera kayendetsedwe ka subcutaneous (s / c): yowonekera, yopanda utoto (1,2 kapena 2.4 ml wa katoni woyikiratu ndi cholembera, pakatoni 1 la syringe cholembera ndi malangizo ogwiritsira ntchito Bayeta).

Muli 1 ml ya yankho:

• yogwira mankhwala: exenatide - 250 mcg,
• zothandiza: metacresol, mannitol, acetic acid, sodium acetate trihydrate, madzi a jakisoni.

Mankhwala

Zomwe zimagwiritsidwa ntchito ndi Baeta ndi exenatide - 39-amino acid aminopeptide, choyerekeza cha glucagon-polypeptide receptors.

Ndi othandizira mwamphamvu ma insretins, monga glucagon-peptide-1 (GLP-1), amene amasintha ntchito ya β-maselo, amalimbikitsa kuteteza shuga kwa glucose, kupondereza katulutsidwe kamatumbo a glucagon, kuchepera m'mimba kutaya (pambuyo polowa m'matumbo kulowa m'magazi ambiri), ndipo kukhala ndi zotsatira zina za hypoglycemic. Chifukwa chake, exenatide imatha kusintha magwiridwe amtundu wa shuga.

Mndandanda wa amino acid wokhudzana ndi exenatide kumlingo wina umafanana ndi kuchuluka kwa anthu a GLP-1, chifukwa chomwe mankhwalawa amamangirira anthu a GLP-1 receptors ndikuwayambitsa. Zotsatira zake, kuphatika kwa glucose komwe kumadalira shuga komanso kubisalira kwa insulin kuchokera ku β-cell ya kapamba kumalimbikitsidwa ndikutenga gawo la cyclic adenosine monophosphate (AMP) ndi / kapena njira zina zowonetsera ma intracellular. Exenatide imalimbikitsa kutulutsidwa kwa insulini kuchokera ku β-cell makamaka pakuwonjezera kuchuluka kwa glucose.

Exenatide ndiosiyana mu kapangidwe ka mankhwala ndi zochita za pharmacological kuchokera ku alpha-glucosidase inhibitors, sulfonylureas, insulin, biguanides, meglitinides, thiazolidinediones ndi D-phenylalanine.

Glycemic control mu mtundu 2 wa shuga imayenda bwino mwa njira zotsatirazi:

• shuga wodalira insulin katulutsidwe: exenatide imakulitsa katulutsidwe kamatenda a shuga amachokera ku ma cell a pancreatic patients mwa odwala omwe ali ndi vuto la hyperglycemic. Pamene kuchuluka kwa shuga m'magazi kumachepa, kutulutsidwa kwa insulini kumachepa, atayandikira zomwe zimachitika, amasiya, potero amachepetsa chiopsezo cha hypoglycemia,
• Gawo loyamba la mayankho a insulin: Mtundu wachiwiri wa shuga, palibe chinsinsi cha insulin panthawi yoyamba ya mphindi 10. Kuphatikiza apo, kutayika kwa gawoli ndikusokonezedwa koyambirira kwa ntchito ya β-cell. Kugwiritsa ntchito kwa exenatide kumabwezeretsa kapena kumakweza gawo loyamba ndi lachiwiri la yankho la insulin,
• glucagon katulutsidwe: vuto la hyperglycemia, exenatide imachepetsa kwambiri katulutsidwe ka glucagon, pomwe sikuphwanya yankho labwinobwino la glucagon ku hypoglycemia,
• Zakudya: Zakudya zam'mimba zimachepetsa kudya, Zotsatira zake, kuchuluka kwa chakudya chomwe
• Kutaya kwa m'mimba: Kupondereza pamimba, kuthamangitsa madzi.

Kugwiritsa ntchito mitundu yachiwiri ya matenda a shuga 2 kuphatikiza ndi thiazolidinedione, kukonzekera kwa metformin ndi / kapena sulfonylurea kumathandizira kuchepetsa kuthamanga kwa glucose wamagazi ndi gluprose wa postprandial, komanso hemoglobin A1c (Hb_A1c), yomwe imakweza glycemic control.

Pharmacokinetics

Pambuyo pa utsogoleri wa sc, exenatide imalowa mwachangu. Avereji ya ndende yayikulu (C_max) imatheka mkati mwa maola 2.1 ndipo imakhala 211 pg / ml.

Dera lomwe lili pansi pa ndende nthawi yayikulu (AUC) pambuyo pa kupatsidwa kwa exenatide pa mlingo wa 10 --g - 1036 pg × h / ml, chizindikirochi chikuwonjezeka molingana ndi kuchuluka kwa mankhwalawa, koma sichikhudza C_max. Zomwezi zimadziwika ndi s / kukhazikitsidwa kwa Baeta pamapewa, pamimba kapena ntchafu.

Gawo Logawa (V_d) pafupifupi malita 28.3. Imapukusidwa makamaka ndi kusefera kwamadzi komwe kumatsatiridwa ndi kuwonongeka kwa proteinolytic. Kuchotsedwako kuli pafupifupi 9.1 l / h. Theka lomaliza la moyo (T_½- - 2.4 maola. Mankhwala a pharmacokinetic magawo a mankhwalawa samadalira mlingo.

Zoyezera zoyezera zimatsimikiziridwa pafupifupi maola 10 pambuyo pakupereka kwa exenatide mlingo.

Pharmacokinetics mwapadera:

• kuwonongeka kwa impso: mofatsa pang'ono modabwitsa kuwonongeka kwa creatinine chilolezo (CC) 30-80 ml / min, kusiyana kwakukulu mu pharmacokinetics of exenatide sikuwonekere, chifukwa chake, kusintha kwa mankhwala sikofunikira. Odwala omwe ali ndi vuto loti aimpso amalephera kudikirira, kuyimitsidwa kwa mankhwalawa kumachepa pafupifupi 0.9 l / h (odwala athanzi - 9.1 l / h),
• chiwindi ntchito: chiwopsezo chachikulu mu plasma ndende ya exenatide sichinapezeke, chifukwa mankhwalawa amachotsedwa makamaka ndi impso,
• m'badwo: pharmacokinetics of exenatide sichinaphunziridwe ana, achinyamata azaka 12-16 zakubadwa ndi mtundu wa 2 matenda a shuga, mukamagwiritsa ntchito exenatide pa mlingo wa 5 μg, mapiritsi a pharmacokinetic ofanana ndi omwe ali ndi odwala akuluakulu adawululidwa, mwa anthu okalamba palibe kusintha pamachitidwe a pharmacokinetic, chifukwa chake, kusintha kwa mlingo sikuchitika. zofunika
• jenda ndi mtundu: kusiyana kwakukulu mu pharmacokinetics of exenatide pakati pa azimayi ndi abambo sikumawonedwa, mpikisano ulibe gawo loonekera pazomwezi,
• Kulemera kwa thupi: Palibe kuphatikiza kwakukulu pakati pa cholembera cha misa ndi exenatide pharmacokinetics komwe kunapezeka.

Zizindikiro zogwiritsidwa ntchito

Monga monotherapy yodwala matenda a shuga a 2, Bayete imagwiritsidwa ntchito kuwonjezera pa chithandizo chamankhwala ndikuchita masewera olimbitsa thupi kuti akwaniritse kuyang'anira koyenera kwa glycemic.

Kuphatikiza kwa mtundu wa matenda a shuga 2, Bayete imagwiritsidwa ntchito pofuna kupititsa patsogolo ulamuliridwe wa glycemic pazotsatirazi:

• kuphatikiza pa metformin / sulfonylurea derivative / thiazolidinedione / metformin + sulfonylurea derivative / metformin + thiazolidinedione,
• kuwonjezera pa kuphatikiza kwa basal insulin + metformin.

Mlingo

Yothetsera subcutaneous makonzedwe.

1 ml yankho lili:

ntchito: exenatide 250 mcg,

zokopa: sodium acetate trihydrate 1.59 mg, acetic acid 1.10 mg, mannitol 43.0 mg, metacresol 2.20 mg, madzi a jekeseni q.s. mpaka 1 ml.

Njira yopanda mawonekedwe.

Zotsatira za mankhwala

Mankhwala a Baeta ndi njira yosapangidwira ya kulowetsedwa kwa subcutaneous. The yogwira pophika mankhwala ndi exenatide, mulinso ochepa sodium acetate trihydrate, metacresol, mannitol, acetic acid, madzi osungunuka. Amamasula mankhwalawo monga ma ampoules (250 mg), iliyonse imakhala ndi cholembera chapadera chokhala ndi voliyumu ya 1.2 ndi 2.4 ml.

Odwala omwe amamwa mankhwalawa amawona kuchepa kwa shuga m'magazi chifukwa cha njira iyi:

1. Byeta amalimbikitsa kutulutsa kwa insulin kuchokera parenchyma ndi kuchuluka kwa shuga m'magazi a munthu.
2. Katemera wa insulini amaima pakadali pomwe pali kuchepa kwa shuga.
3. Gawo lomaliza ndikukhazikika m'magazi anu.

Mwa anthu omwe ali ndi vuto lachiwiri la matenda ashuga, kugwiritsa ntchito mankhwalawa kumabweretsa kusintha kotere:

• Kupewa kwambiri kwa glucagon kupanga, komwe kumachepetsa insulin.
• Kuletsa kwa gastric motility.
• Anachepetsa chilako.

Mankhwalawa akaperekedwa mobwerezabwereza, chinthu chogwira ntchito chimayamba kugwira ntchito nthawi yomweyo ndikuchita bwino kwambiri patatha maola awiri.

Mphamvu ya mankhwalawa imayima kokha pambuyo pa tsiku.

Malangizo ogwiritsira ntchito mankhwalawa

Dokotala wokhayo amene angakupatseni mankhwala omwe mungamwe, musayankhe nokha. Mutapeza mankhwala a Baeta, malangizo ogwiritsa ntchito ayenera kuphunziridwa mosamala.

Chizindikiro chogwiritsira ntchito mankhwalawa ndi mtundu 2 wa shuga wokhala ndi mono- kapena mankhwala owonjezera. Amagwiritsidwa ntchito pomwe sizingatheke kuyendetsa bwino glycemia. Mankhwalawa angagwiritsidwe ntchito limodzi ndi njira zotere:

1. Metformin
2. Thokozani,
3. zochokera sulfonylurea,
4. kuphatikiza kwa metformin, sulfonylurea,
5. kuphatikiza kwa metformin ndi thiazolidinedione.

Mlingo wothetsera vutoli ndi 5 μg kawiri pa tsiku kwa ola limodzi musanatenge mbale yayikulu. Amabayidwa pang'onopang'ono m'manja, ntchafu kapena pamimba. Pakatha mwezi wopambana, mankhwalawa amawonjezedwa mpaka 10 mgg kawiri pa tsiku. Ngati mankhwalawa agwiritsidwa ntchito limodzi ndi zotumphukira za sulfonylurea, mlingo wotsiriza uyenera kuchepetsedwa kuti muchepetse kudwala kwa wodwala.

Malamulo otsatirawa operekera mankhwalawa akuyenera kuonedwanso:

• sichingagwiritsidwe ntchito mukatha kudya,
• sikofunikira kubaya jekeseni kapena kudzera m'mitsempha,
• Ngati yankho lake ndi la mitambo komanso losintha, ndibwino kuti muzigwiritsa ntchito,
• ngati tinthu tating'onoting'ono tapezeka mu njirayi, muyenera kusiya kukonzekera kwa mankhwalawo.
• Munthawi ya chithandizo cha Bayeta, kupangira antibody ndikotheka.

Mankhwalawa amayenera kusungidwa m'malo otetezedwa ku kuwala komanso kwa ana aang'ono. Kutentha kosungirako kuyenera kuwonedwa kuyambira madigiri 2 mpaka 8, motero ndibwino kusunga mankhwalawo mufiriji, koma osawuma.

Alumali moyo wa malonda ndi zaka 2, ndipo yankho mu cholembera ndi mwezi umodzi pakutentha kosaposa 25 digiri.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Ndi yankho la subcutaneous management. Mu syringe cholembera imatha kukhala 1.2 kapena 2.4 ml ya yogwira ntchito. Phukusili limakhala ndi cholembera chimodzi.

Kuphatikizikako ndikuphatikizapo:

• exenatide - 250 mcg,
• sodium acetate thunthu,
• glacial acetic acid,
• mannitol
• metacresol
• madzi a jakisoni.

"Baeta Long" ndi ufa wokonzekera kuyimitsidwa, wogulitsidwa wathunthu ndi zosungunulira. Mtengo wa mankhwalawa ndiwokwera kwambiri, umagwiritsidwa ntchito nthawi zambiri. Imaperekedwa pokhapokha.

Zotsatira za pharmacological

Ili ndi vuto la hypoglycemic. Kwambiri bwino magazi kuwongolera shuga, kutsegula ntchito ya pancreatic beta maselo, kukakamiza katulutsidwe katemera wa glucagon, timapitiriza shuga-wodalira insulin katulutsidwe ndipo amachepetsa m'matumbo kutulutsa.

Exenatide ndi yosiyana pakapangidwe ka insulin, sulfonylurea ndi zinthu zina, chifukwa chake sichingakhale cholowa m'malo chamankhwala.

Odwala omwe amamwa mankhwala a Bayeta amachepetsa kudya, amasiya kulemera, komanso amakhala bwino.

Contraindication

• Hypersensitivity pamagawo ake,
• Matenda owopsa am'mimba ndipo ali ndi concomitant gastroparesis,
• Mbiri ya matenda ashuga a ketoacidosis,
• Kulephera kwakukulu kwaimpso,
• Mtundu woyamba wa shuga
• Mimba komanso kuyamwa
• Age ali ndi zaka 18.

Malangizo ogwiritsira ntchito (njira ndi Mlingo)

Mankhwalawa amaperekedwa mwachangu pamimba, m'mapewa, m'chiuno kapena matako. Tsamba la jakisoni liyenera kusinthidwa pafupipafupi. Yambani ndi mlingo wa 5 mcg kawiri tsiku lililonse musanadye. Mutha kuonjezera mlingo mpaka 10 mcg kawiri pa tsiku pambuyo pa masabata anayi, ngati akuwonetsedwa. Ndi mankhwala ophatikiza, kusintha kwa sulfonylurea ndi zotumphukira kwa insulin kungafunike.

Zotsatira zoyipa

• Hypoglycemia (pamodzi ndi mankhwala)
• Anachepetsa chilako
• Dyspepsia
• Gastroesophageal Reflux,
• Lawani kuvulaza,
• Kupweteka kwam'mimba
• Kusanza, kusanza,
• Kutsegula m'mimba
• Kudzimbidwa
• Zachisangalalo
• Kugona
• Chizungulire
• Mutu
• Zotsatira zoyipa zamagetsi,
• Zotsatira zoyipa zam'deralo m'malo a jakisoni,
• Anaphylactic mantha,
• Hyperhidrosis,
• Kuthetsa madzi m'thupi
• Pachimake kapamba (kawirikawiri)
• Kulephera kwa impso (osowa).

Bongo

Zizindikiro zotsatirazi ndizotheka ndi bongo:

• Hypoglycemia. Imadziwoneka ngati kufooka, nseru ndi kusanza, kusokonezeka kwa chikumbumtima mpaka kutaya kwake chikomokere, njala, chizungulire, ndi zina zina. Ndikokwanira pang'ono, ndikokwanira kudya malonda omwe amapezeka mu chakudya. Pankhani ya hypoglycemia yolimbitsa kwambiri komanso yoopsa, jekeseni wa glucagon kapena dextrose yofunikira, mutatha kumubweretsa munthuyo - chakudya chomwe chili ndi chakudya. Onetsetsani kuti mwatsimikiza kuti mulumikizane ndi katswiri kuti asinthe mlingo.
• Zovuta, limodzi ndi mseru komanso kusanza. Chithandizo chachikulu cha mankhwalawa chimagwiritsidwa ntchito, kuthandizira kuchipatala ndikotheka.

Kuyanjana kwa mankhwala osokoneza bongo

Muyenera kukambirana ndi dotolo wanu kumwa mankhwala omwe amafunikira kuti muchotsere m'mimba, chifukwa "Baeta" imachepetsa kuchotsa m'mimba ndipo, monga chotulukapo chake, mankhwalawa.

Maantibayotiki ndi zinthu zofanana ndi izi ziyenera kugwiritsidwa ntchito ola limodzi musanagwiritse jakisoni wa "Bayeta" kapena panthawi ya zakudya zomwe mankhwalawa sagwiritsidwa ntchito.

Kuchepetsa ndende ya digoxin, lovastatin, kumawonjezera nthawi yayitali ya lisinopril ndi warfarin.

Mwambiri, momwe zotsatira za mankhwala ena sizinaphunziridwe pang'ono. Izi sizikutanthauza kuti zisonyezo zoopseza moyo zinalemekezedwa pa nthawi ya mgwirizano. Chifukwa chake, funso la kuphatikiza mankhwala a Bayetoy ndi mankhwala ena limakambidwa payekhapayekha ndi adokotala.

Malangizo apadera

Sichingachitike pambuyo chakudya. Musati mupeze jakisoni kapena m'mitsempha.

Ngati pali kuyimitsidwa mu yankho kapena turmidity, mankhwalawa sayenera kugwiritsidwa ntchito.

Zimatsimikiziridwa mwachipatala kuti mankhwalawa amakhudza kulemera kwa thupi, kuchepetsa kulakalaka.

Sigwiritsidwa ntchito mwa anthu omwe ali ndi vuto lalikulu la impso.

Itha kuyambitsa kupweteka kwam'mimba, koma ilibe matenda.

Wodwala amayenera kuwunika kusintha kwa thanzi lawo panthawi yamankhwala. Ndi chitukuko cha zovuta pachimake, muyenera kufunsa dokotala ndikusiya kumwa.

Sichigwiritsidwa ntchito ngati cholowa m'malo mwa insulin.

Mukatengedwa ndi metformin kapena sulfonylurea, zimatha kukhudza kuyendetsa galimoto. Nkhaniyi yathetsa ndi dokotala.

MTHANDIZO. Mankhwala amaperekedwa pokhapokha ngati mwalandira mankhwala!

Gwiritsani ntchito muubwana ndi ukalamba

Palibe chidziwitso cha mankhwalawa pa thupi la ana osakwana zaka 18, chifukwa chake, sichikugwiritsidwa ntchito pochita zawo. Ngakhale pali chidziwitso chogwiritsidwa ntchito mwa ana kuyambira zaka 12, Zizindikiro zamankhwala zinali zofanana ndi za akulu. Koma nthawi zambiri njira zina zimakhazikitsidwa.

Itha kugwiritsidwa ntchito pochiza odwala okalamba. Komabe, muyenera kuwunika momwe anthu omwe ali ndi mbiri ya ketoacidosis kapena omwe ali ndi vuto laimpso. Odwala oterewa amalangizidwa kuti azichita mayeso pafupipafupi.

Yerekezerani ndi mankhwala ofanana

Mankhwala odula awa ali ndi ma analogu omwe amathanso kugwiritsidwa ntchito pochiza matenda ashuga. Tiyeni tiwone madera awo mwatsatanetsatane.

Kugwiritsa ntchito analogues kumatheka pokhapokha ndi chilolezo cha adokotala. Kudzipatsa nokha koletsedwa!

Anthu amadziwa kuti zoyipa sizimachitika kawirikawiri, nthawi zambiri zimakhala ndi mlingo wosankhidwa bwino. Zotsatira za kuchepa thupi zimatchulidwa, ngakhale sizomwezo zonse. Mwambiri, "Bayeta" imawunika anthu odwala matenda ashuga omwe akudziwa zambiri.

Alla: “Ndakhala ndikugwiritsa ntchito mankhwalawa kwa zaka ziwiri.Munthawi imeneyi, shuga amabwerera mwakale, ndipo kulemera kwake kunachepa ndi 8 kg. Ndimakonda kuti imagwira ntchito mwachangu komanso popanda mavuto. Ndikukulangizani. ”

Oksana: "Baeta" ndi njira yodula, koma imathandizira ndi matenda a shuga. Shuga amapitilira chimodzimodzi, zomwe ndimakondwera nazo. Sindinganene kuti amachepetsa kwambiri kulemera, koma ndinasiya kuyambiranso. Koma kulakalaka kumawongolera. Ndikufuna kudya zochepa, chifukwa chake kulemera kwakhalapo nthawi yayitali. Nthawi zambiri, ndimakhutira ndi mankhwalawa. ”

Igor: “Anandipatsa mankhwalawa kuti andipatse chithandizo nditamwa mapiritsi anga akale. Mwambiri, chilichonse chimakwanira, kupatula mtengo wokwera kwambiri. "Bayetu" sichingatheke pazopindulitsa, muyenera kulamula pasadakhale. Uku ndiye kusokonekera kokhako. Sindikufuna kugwiritsa ntchito ma analogu pano, koma ndi angakwanitse. Ngakhale ndikutha kudziwa kuti ndinamva kusintha kwake msanga - masabata angapo atangoyamba kumwa. Chikhumbo chinachepa, motero adachepetsa thupi nthawi yomweyo. ”

Pomaliza

"Baeta" ndi mankhwala othandiza omwe amadziwika kwambiri pakati pa odwala matenda a shuga. Nthawi zambiri amamuika mankhwala ena akasiya kugwira ntchito. Ndipo mtengo wokwera umatha chifukwa cha kuwonjezeka kwa kuchepa thupi komanso kuwonetsa kovuta kwa odwala omwe akupatsidwa chithandizo. Chifukwa chake, "Bayeta" nthawi zambiri imakhala ndi malingaliro abwino kuchokera kwa onse omwe amagwiritsa ntchito mankhwalawa ndi madokotala.

Zizindikiro ndi contraindication

Kuchita bwino kwa mankhwalawo kunatsimikiziridwa m'mayesero 6 osasankhidwa omwe jakisoni imodzi ya exenatide (2 mg) ikufanizidwa ndi mankhwala ena. Maphunzirowa adakhudza anthu omwe adalandira kale chithandizo choyambirira cha matenda a shuga (kudya + zolimbitsa thupi, nthawi zina ndi mankhwala omwe alipo). Odwala anali ndi HbA1c yapakati pa 7.1 ndi 11% komanso kulemera kwamtondo wolimba ndi BMI ya 25 mpaka 45 kg / m2.

Kuyerekeza kwapadera kwa mankhwalawa kumatenga milungu 30 kapena 24. Anthu okwana 547, oposa 80% omwe adatenga metformin ndi sulfonylurea kapena pioglitazone, adatenga nawo gawo pa kafukufukuyu. Kukonzekera kosasinthika kunapereka zotsatira zabwino kwambiri poyerekeza ndi HbA1c: HbA1c yatsika ndi 1.9% ndi 1.6%, motsatana.

Pakufufuza kwamaso kawiri komwe kunatenga milungu 26, asayansi anayerekezera sitagliptin, pioglitazone, ndi exenatide. Phunziroli linakhudza anthu 491 omwe sanayankhe kulandira chithandizo ndi metformin. Mukamathandizidwa ndi exenatide, kuchuluka kwa HbA1c kumatsika ndi 1.5%, komwe kumakhala kwakukulu kwambiri kuposa pioglitazone ndi sitagliptin. Mukatenga "Bayeta", kutikita minofu yotsika ndi 2.3 kg.

Mankhwala ndi contraindicated pa mimba ndi mkaka wa m`mawere. Ngati mimba yakonzekera, mankhwalawo ayenera kusiyidwa osachepera miyezi itatu isanakwane. Odwala ochepera zaka 18 sangathe kugwiritsa ntchito mankhwalawa chifukwa sanaphunziridwe mu gulu ili. Ndi kulephera kwa aimpso, pamakhala chiopsezo chowonjezereka cha mavuto. Odwala okhala ndi creatinine chilolezo pansi pa 30 ml / mphindi sayenera kulandira mankhwala.

Mankhwala omwe amafunika kuperekedwa kamodzi pa sabata ndi abwino. Komabe, mankhwalawa omwe amakhala m'thupi kwa masabata osachepera 10 nawonso atha kukulitsa mavuto obwera kwanthawi yayitali.

Kuchita

Exenatide ingakhudze mayendedwe am'mimba, kuchuluka komanso kuchuluka kwa mankhwala ena. Mankhwala amatha kuonjezera chiopsezo cha hypoglycemia mukamamwa insulin ndi sulfonylurea. Kugwiritsidwa ntchito kophatikizira kwa ma anticoagulants akuwonetsedwa kuti kumachepetsa magazi.

Ma analogues (omwe ali ndi zinthu zofanana) za mankhwalawa:

Maganizo a wodwala ndi adokotala za mankhwalawa.

Dotolo adayikira mapiritsi, chifukwa mankhwalawa sankagwira ntchito. Ndiyenera kunena nthawi yomweyo - chida chodula kwambiri. Ndinafunika kugula mapaketi angapo, zomwe zimawononga ndalama zonse. Komabe, zotsatira zake ndizoyenera kugula - zinthu zasintha kwambiri. Sindikumva chilichonse chosasangalatsa. Mamita akuwonetsa zofunikira kwa miyezi ingapo.

"Baeta" ndi mankhwala okwera mtengo omwe amalembedwa chifukwa cholephera kugwiritsa ntchito mankhwala ena othandizira odwala matenda ashuga. Kugwiritsa ntchito nthawi yayitali (malinga ndi malangizo aboma) kumachepetsa kwambiri glycemia komanso kukonza mkhalidwe wa odwala, "ndizotheka".

Boris Alexandrovich, katswiri wa matenda ashuga

Mtengo (mu Russian Federation)

Mtengo wa chithandizo ndi ma ruble 9000 kwa masabata anayi. Mankhwala ena othandizira odwala matenda ashuga ndi otsika mtengo kwambiri, metformin (yonse, 2 g / tsiku) imakhala yotsika ndi ruble 1000 pamwezi.

Uphungu! Musanagule mankhwala aliwonse, katswiri wophunzitsidwa ayenera kufunsidwa. Kuchita nokha mankhwala mosaganizira kungayambitse zotsatira zosayembekezeka komanso kuwononga ndalama zambiri. Dokotala adzakuthandizani kuti mupeze njira yoyenera komanso yolondola yothandizira, chifukwa chake pakakhala chizindikiro choyambirira muyenera kufunsa chithandizo chamankhwala.

Mtengo wa mankhwalawa ndi kuwunika

Mankhwala a Baeta atha kugulidwa ku pharmacy iliyonse kapena kuyika oda pa pharmacy ya pa intaneti. Dziwani kuti mankhwalawo amagulitsidwa kokha ndi mankhwala. Popeza wopanga izi ndi Sweden, motero mtengo wake ndi wokwera kwambiri.

Chifukwa chake, sikuti munthu wamba aliyense amene ali ndi matenda a shuga sangathe kugula mankhwalawa. Mtengo umasiyanasiyana kutengera mtundu wa ndalama zomwe zimatulutsidwa:

• 1.2 ml syringe cholembera - kuchokera 4246 mpaka 6398 rubles,
• 2.4 ml syringe cholembera - kuyambira 5301 mpaka 8430 rubles.

Posachedwa adachita kafukufuku wotsatsa malonda, omwe adasankhidwa ndi odwala osankhidwa mwadala. Ponena za mankhwala a Byeta, omwe ndemanga zake zikuwonetsa kukhalapo kwa zotsatirazi zotsatirazi:

1. Kusokoneza kwamanjenje: kutopa, kupotoza kapena kusowa kwa kukoma.
2. Kusintha kwa kagayidwe kazakudya ndi zakudya: kuchepa thupi, kuchepa thupi chifukwa chakusanza.
3. Nthawi zosowa kwambiri za anaphylactic reaction.
4. Mavuto am'mimbamo am'mimba komanso ma pathologies: kuwonjezereka kwa mapangidwe a gasi, kudzimbidwa, kapamba kovuta (nthawi zina).
5. Zosintha pakukodza: ​​Matenda aimpso, kuwonjezeka kwa creatinine, kulephera kwa aimpso kapena kukula kwake.
6. Thupi lawo siligwirizana: alopecia (tsitsi kutayika), kuyabwa, urticaria, angioedema, maculopapular totupa.

Zachidziwikire, mfundo yosatsutsika ndi mtengo wokwera wa mankhwalawa, ndichifukwa chake odwala ambiri omwe ali ndi matenda ashuga kusiya malingaliro awo pa intaneti. Koma, ngakhale izi, mankhwalawo amachepetsa shuga m'magazi a wodwala ndikuthandizira kulimbana ndi kunenepa kwambiri.

Komanso, chifukwa chachilendo chake chothandizira, sichimayambitsa kuukira kwa hypoglycemia.

Mitu ya mankhwalawa

Ngati wodwalayo sangaperekedwe njira zotere kapena akuyamba kukumana ndi zovuta, dokotala yemwe akupezekapo amatha kusintha njira zamankhwala. Izi zimachitika m'njira ziwiri zazikulu - posintha kuchuluka kwa mankhwalawo kapena kuwasiya kwathunthu. Pachiwiri, ndikofunikira kusankha mankhwala a analog omwe angakhale ndi chithandizo chofanana komanso osavulaza odwala matenda ashuga.

Mwakutero, Baeta ilibe njira yofananira. Makampani a AstraZeneca ndi Bristol-Myers squibb Co (BMS) okha omwe amapanga 100% analogues ya mankhwalawa (ma generics). Pali mitundu iwiri ya mankhwala pamsika wogulitsa ku Russia, omwe ali ofanana pachithandizo chawo. Izi zikuphatikiza:

1. Victoza ndi mankhwala omwe, monga Baeta, ndi oyerekeza incretin. Mankhwala amapangidwanso mu mawonekedwe a syringe pens for subcutaneous infusions mu mtundu 2 shuga. Kugwiritsa ntchito mankhwalawa pafupipafupi kumathandizira kuchepetsa kuchuluka kwa hemoglobin ya glycated mpaka 1.8% ndikuchepera makilogalamu 4-5 owonjezera pachaka chamankhwala. Tiyenera kudziwa kuti adokotala okha ndi omwe angadziwe zoyenera zamankhwala ena. Mtengo wapakati (ma syringe 2 a 3 ml) ndi ma ruble 10,300.
2. Januvia ndi njira yotsitsira ya incretin yomwe imachepetsa shuga m'magazi pochiza matenda amtundu wa 2 shuga. Amapezeka piritsi. Mtengo wapakati wamankhwala (mayunitsi 28, 100 mg) ndi ma ruble 1672, omwe ndi otsika mtengo kwambiri pakati pamankhwala omwe amafunsidwa. Koma funso loti njira yanji yothetsera vutoli ndiyabwino kutsalira pakutha kwa dokotala.

Ndipo, choncho, mankhwala a Bayeta ndi othandizira a hypoglycemic. Zithandizo zake zothandizira zimakhala ndi zina zomwe zimathandizira kuti azitha kuyang'anira kwathunthu glycemic. Komabe, mankhwalawa nthawi zina sangathe kugwiritsa ntchito, amathanso kuyambitsa mavuto.

Chifukwa chake, kudzipereka nokha sikofunika. Ndikofunikira kupita ndiulendo wopita kwa dokotala yemwe amaunika momwe angagwiritsire ntchito mankhwalawa, poganizira mawonekedwe a thupi la wodwala aliyense. Mankhwala olondola ndikutsatira malamulo onse oyambitsa yankho, mutha kuchepetsa shuga kukhala milingo yabwinobwino ndikuchotsa zisonyezo za hyperglycemia. Kanemayo munkhaniyi akukamba za mankhwala a shuga.

Mankhwala

Exenatide (Exendin-4) ndi glucagon-polypeptide receptor agonist ndipo ndi 39-amino acid amidopeptide. Ma insretins, monga glucagon-peptide-1 (GLP-1), amalimbikitsa kuteteza shuga m'magazi, amasintha ntchito ya beta, kuponderezana mosabisa kutulutsa glucagon ndikuchepetsa m'matumbo atalowetsa magazi ambiri kuchokera m'matumbo. Exenatide ndi mphamvu ya insretin mimetic yomwe imathandizira secretion ya glucose yodalira shuga ndipo imakhala ndi zotsatira zina za hypoglycemic zomwe zimapangidwira ma incretins, zomwe zimapangitsa kuti glycemic control mwa odwala omwe ali ndi matenda a shuga a 2.

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 othamanga ndi kutenga kwa cyclic AMP ndi / kapena ma signature a intracellular njira. Exenatide imalimbikitsa kutulutsa kwa insulin kuchokera ku maselo a beta pamaso pa kuchuluka kwa shuga. Exenatide amasiyana mu kapangidwe ka mankhwala ndi zochita za pharmacological kuchokera ku 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.

Katemera wa glucose yemwe amadalira khungu: mu hyperglycemic zinthu, exenatide timapitiriza shuga kutengera amadalira insulin kuchokera pancreatic beta maselo. Katemera wa insuliniyu amathera pomwe kuchuluka kwa glucose m'magazi kumachepera ndipo kumayandikira mwachizolowezi, potero kumachepetsa chiopsezo cha hypoglycemia.

Gawo loyamba la yankho la insulin: katemera wa insulin mphindi 10 zoyambirira, zomwe zimadziwika kuti "gawo loyamba la mayankho a insulin", palibe odwala omwe ali ndi matenda a shuga 2. 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.

Katemera wa Glucagon: Odwala omwe ali ndi matenda a shuga 2 amachokera ku hyperglycemia, makonzedwe a exenatide amachepetsa kubisala kwa glucagon. Komabe, exenatide sichimasokoneza mayankho abwinobwino a glucagon ku hypoglycemia.

Zakudya: makonzedwe a exenatide amatsogolera kuchepa kwa njala komanso kuchepa kwa chakudya.

Kuchotsa mafuta m'mimba: zidawonetsedwa kuti makina amtundu wa exenatide amalepheretsa kuthamanga kwa m'mimba, komwe amachepetsa kutsitsa kwake. Odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga, mankhwalawa a exenatide mu monotherapy komanso ophatikizana ndi metformin ndi / kapena sulfonylurea amakonzekera kutsika kwa magazi ndende ya glucose, kuperewera kwa shuga m'magazi, komanso HbA1c, potero kuwongolera kayendedwe ka glycemic mwa odwala.

Pharmacokinetics

Pambuyo subcutaneous makonzedwe kwa odwala a mtundu 2 matenda a shuga, exenatide mofulumira odzipereka ndipo ukufika pafupifupi pazipita plasma wozungulira pambuyo 2.1 maola. Chiyero chachikulu kwambiri (Cmax) ndi 211 pg / ml ndi malo onse omwe ali munthawi ya ndende (AUC_0-int) ndi 1036 pg x h / ml itatha kuperekera kwapakati pa 10 μg exenatide. 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 phewa.

Voliyumu yogawa exenatide pambuyo subcutaneous makonzedwe ndi 28.3 malita.

Kutetemera ndi chimbudzi

Exenatide imapangidwa makamaka ndi kusefera kwa glomerular kutsatiridwa ndi kuwonongeka kwa proteinolytic. Chilolezo cha Exenatide ndi 9.1 l / h ndipo theka lomaliza la moyo ndi maola 2.4. Izi pharmacokinetic machitidwe a exenatide ndi kumwa palokha. Miyezo yoyeserera ya exenatide imatsimikiziridwa pafupifupi maola 10 mutatha dosing.

Magulu apadera a odwala

Odwala ndi mkhutu aimpso ntchito

Odwala omwe ali ndi vuto laimpso wofatsa kapena wowongoletsa (mawonekedwe a creatinine chilolezo cha 30-80 ml / min), chilolezo cha exenatide sichosiyana kwambiri ndi chilolezo chamankhwala omwe ali ndi vuto laimpso, motero, kusintha kwa mankhwalawa sikofunikira. Komabe, mwa odwala omwe ali ndi vuto la aimpso omwe amalephera kudutsa dialysis, kuvomerezedwa kwapakati kumachepetsedwa kukhala 0,9 l / h (poyerekeza ndi 9.1 l / h m'maphunziro athanzi).

Odwala omwe ali ndi vuto la chiwindi

Popeza exenatide imapukusidwa kwambiri ndi impso, akukhulupirira kuti kuwonongeka kwa hepatic sikusintha kuchuluka kwa exenatide m'magazi. Okalamba M'badwo sizikhudza mawonekedwe a pharmacokinetic a exenatide. Chifukwa chake, odwala okalamba sayenera kuchita kusintha kwa mlingo.

Ana Ma pharmacokinetics a exenatide mwa ana sanaphunzire.

Achinyamata (azaka 12 mpaka 16)

Mu kafukufuku wa pharmacokinetic omwe amapangidwa ndi odwala omwe ali ndi matenda a shuga 2 omwe ali ndi zaka 12 mpaka 16, kuyang'anira exenatide pa mlingo wa 5 μg kumayendera limodzi ndi magawo a pharmacokinetic ofanana ndi omwe amawonera anthu akuluakulu.

Palibe kusiyana kwakanema pakati pa amuna ndi akazi omwe ali mu pharmacokinetics of exenatide. Mtundu Mpikisano ulibe tanthauzo lililonse pa pharmacokinetics of exenatide. Kusintha kwa dose malinga ndi mtundu wake sikofunikira.

Odwala onenepa

Palibenso kulumikizana kowoneka bwino pakati pa body index index (BMI) ndi exenatide pharmacokinetics. Kusintha kwa Mlingo woyambira BMI sikofunikira.

WOPHUNZITSA

Baxter Pharmaceutical Solutions ELC, USA
927 South Curry Pike, Bloomington, Indiana, 47403, USA
Baxter Pharmaceutical Solutions LLC, USA
927 South Curry Pike, Bloomington, Indiana 47403, USA

FILLER (PRIMARY PackING)

1. Baxter Pharmaceutical Solutions ELC, USA 927 South Curry Pike, Bloomington, Indiana, 47403, USA Baxter Pharmaceutical Solutions LLC, USA 927 South Curry Pike, Bloomington, Indiana 47403, USA (katiriji)

2. Sharp Corporation, USA 7451 Keebler Way, Allentown, PA, 18106, USA Sharp Corporation, USA 7451 Keebler Way, Allentown, Pennsylvania, 18106, USA (msonkhano wama cartridge mu cholembera)

PACKER (SECONDARY (CONSUMER) PACKAGING)

Enestia Belgium NV, Belgium
Kloknerstraat 1, Hamont-Ahel, B-3930,
Belgium Enestia Belgium NV, Belgium
Klocknerstraat 1, Hamont-Achel, B-3930, Belgium

MALANGIZO OTHANDIZA

AstraZeneca UK Limited, UK
Silk Road Business Park, Mcclesfield, Cheshire, SK10 2NA, UK
AstraZeneca UK Limited, United Kingdom brSilk Road Business Park, Macclesfield, Cheshire, SK10 2NA, United Kingdom

Dzina, adilesi ya bungwe lovomerezedwa ndi yemwe ali ndi mwiniwake kapena mwiniwake wa satifiketi yolembetsera mankhwala kuti agwiritse ntchito kuchipatala kuvomera zomwe ogula akufuna:

Chiyimidwe cha AstraZeneca UK Limited, United Kingdom,
ku Moscow ndi AstraZeneca Pharmaceuticals LLC
125284 Moscow, st. Kuthamanga, 3, p. 1

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.

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. Ndikofunika 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 chake, 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. Mankhwalawa 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 wothandizirayu, kuyang'anira kayendedwe ka magazi konse 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. Ogulitsa ma ruble 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 rubles.

Kodi njira yabwino yogwiritsira ntchito kuchokera pamitundu yonseyi ndi iti? Zimatengera kusanthula 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 (https://med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) kuti mankhwalawo sanamuyenere iye konse: kudumpha kwa shuga ndi jakisoni ndikosavomerezeka. Mkaziyo adangosintha mankhwalawo, pambuyo pake mkhalidwe wake wabwinanso. Amalemba kuti chinthu chachikulu ndikusunga chakudya.

Dmitry akuti (https://med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) kuti wakhala akugwiritsa ntchito mankhwalawa kwa chaka chimodzi tsopano. 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 (https://med-otzyv.ru/lekarstva/144-b/35082-baeta#scomments) kuti mankhwalawa ndiabwino, koma majekeseniwo sawalekerera 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 mumvera chidwi ndi kuwunika kwa wodwala, mankhwalawa sakhala konsekonse.

Sungani kapena gawani: