Mapiritsi a odwala matenda ashuga

Mankhwala omwe ali mu Siofor ndi metformin hydrochloride. Mankhwala amapangidwa mwanjira ya mapiritsi a 500, 850 ndi 1000.

Mankhwalawa amadziwika kuti ndiwodziwika kwambiri padziko lonse lapansi. Mankhwala a hypoglycemic ali m'gulu la odwala omwe ali ndi vuto la matenda ashuga, mankhwalawa amtundu wachiwiri wa matenda a shuga, odalira insulin. Ngati matenda ashuga amakakamizidwa ndi kunenepa kwambiri, mankhwalawa amathandizanso, makamaka ngati chakudya chamagulu sichigwirizana ndi ntchito yake.

Chifukwa cha ntchito:

zimakhudza kuchuluka kwa insulin m'magazi, kusintha kwake,
metformin imathandizira mayamwidwe a shuga mu minofu mu adipose minofu,
chifukwa cha chinthu, magazi mu chiwindi amayamba
kutembenuka kwa insulin kukhala glycogen kwathandizira,
Amatha kuyambitsa kuchepa kwakudya, komwe kumathandiza odwala kutsatira zakudya,
thunthu zimachitika pang'onopang'ono digestibility wa chakudya.

Mlingo wa mankhwala a shuga umayikidwa malinga ndi kuchuluka kwa shuga m'magazi. Nthawi zambiri amayamba piritsi limodzi la 2 la matenda a shuga tsiku lililonse, komanso kuwonjezeka kwapang'onopang'ono kwa nthawi 1 pa sabata. Mlingo sikukula ndi piritsi limodzi pakadutsa masiku 7 kuti mupewe kukhumudwa kosavomerezeka.

Mulingo wambiri watsiku ndi tsiku wa magalamu atatu ndi mapiritsi 6 a Siofor 500 kapena mapiritsi atatu a Siofor 1000.

Chithandizo cha matenda ashuga okhala ndi mapiritsi a Siofor sitingathe kuchitika ngati wodwala akudya zosakwana kilocalories 1000 patsiku. Komanso, odwala omwe ali ndi mtundu woyamba amaphatikizidwa pano, chifukwa izi zimabweretsa kukula kwa hypoglycemia.

pamaso pa matenda a matenda ashuga ketoacidosis,
chikomokere
vuto la mtima
matenda oopsa
kutsika kwamtima
zotupa
matupi awo sagwirizana ndi thunthu.

Zotsatira zoyipa za mankhwalawa, kutsegula m'mimba, kulawa kwazitsulo mkatikati mwa mkamwa, mseru, kusanza kumadziwika, pali ziwengo pakhungu.

Ngati chithandizo cha Siofor ndi cha anthu achikulire patatha zaka 65, ndiye kuti impso zimayambitsidwa. Mlingo ukasankhidwa molakwika, kufooka kwa impso kumayamba.

Glucophage ndi glucophage kutalika kwa matenda ashuga

Mapiritsi a odwala matenda ashuga Glucophage amaikidwa ngati othandizira omwe angachepetse kuyamwa kwa chakudya chamafuta, omwe ali ndi phindu pa magwiridwe antchito a kapamba. Mlingo wapamwamba wa anthu odwala matenda ashuga ndi 500 kapena 850 mg wa mankhwala othandizira, omwe amatengedwa katatu patsiku. Kumwa mankhwalawa pakudya kapena mutatha kudya.

Popeza kumwa mankhwalawo kangapo patsiku, kuopseza kwa zotsatira zoyipa. Kuti muchepetse kupsa mtima kwa mankhwalawo, mawonekedwe a mankhwalawa adasintha. Mtundu wautali wa mankhwala umapangitsa kumwa mapiritsi 1 kamodzi patsiku.

Chodabwitsa cha glucophage yayitali ndikumasulidwa pang'onopang'ono kwa chinthucho, chomwe sichimaphatikizira kudumpha kwamphamvu mu metformin mu plasma.

Kugwiritsa ntchito mankhwala osokoneza bongo a matenda a shuga a 2, odwala amawoneka:

colic
kusanza
kulawa kwazitsulo pakamwa.

Pamaso pa mawonetseredwe otere, mankhwalawa amtundu wa shuga wachiwiri amathetsedwa ndipo chithandizo chamankhwala chimachitika.

Mankhwala Opanda Matenda a shuga

Glucagon ngati peptide 1 receptor agonists ndiwo m'badwo waposachedwa wa mankhwala opangidwa kuchiza matenda a shuga a 2. Mankhwala oterewa samakhudza kwambiri shuga, koma amachepetsa kudya.

Mu matenda a shuga, mankhwalawa amachepetsa kuyenda kwa zomwe zidadyedwa kuchokera m'mimba kupita m'matumbo, ndikuwonjezera kukhumudwa. Mankhwala oterewa ochizira matenda amishuga a 2 ndiwothandiza kwambiri kwa odwala omwe akudwala kwambiri. Agonists amangotulutsa jakisoni wokha.

Zomwe zimaphatikizira:

Agonists - mankhwala atsopano a matenda a shuga a 2, alibe analogue.

Amatha kuyambitsa chitukuko cha kapamba, koma kuwopseza sikutanthauza. Kwa odwala omwe ali ndi vuto la kususuka, mankhwalawa adzakhala opindulitsa. Amaphatikizidwa kubayira mankhwala kwa iwo omwe ali ndi kapamba.

Dipeptidyl peptidase 4 inhibitors ndi mankhwala atsopano pochizira matenda a mtundu 2. Amatha kuchepetsa shuga popanda kuthana ndi kapamba komanso chiopsezo cha hypoglycemia.

Mapale omwe ali mgululi:

Mtundu 2 wa sodium glucose cotransporter zoletsa ndi mbadwo watsopano wamankhwala amitundu iwiri a shuga. Mankhwalawa a matenda a shuga a mtundu wachiwiri amayikidwa kuti magazi a shuga asathenso Kumwa mapiritsi a shuga awa kuloleza kuti mkodzo utulutsidwe ndi impso pomwe ndende ya magazi ili kale ndi 6mm mmol / L. Glucose, yemwe sangathe kuloledwa ndi thupi, amachoka mkodzo, womwe ndi wofunikira kuti magazi azithamanga, azikondweretsa mapangidwe a zovuta za matendawa.

Lemberani mapiritsi a shuga a 2 odwala okalamba:

Mankhwala ali ndi mawonekedwe a syringe, yosavuta kugwiritsa ntchito. Pali timadzi tating'onoting'ono tomwe timapangidwa ndi chakudya, timene timayamwa m'mimba.

Kuphatikiza apo, kapamba amakondoweza, chifukwa cha ichi pali shuga yogwira. Amapereka jakisoni ola limodzi asanadye.

Ikani mankhwalawa 1 nthawi patsiku. Jakisoni wokhazikika amaperekedwa musanadye, popeza nthawi imeneyi munthu wodwala matenda ashuga amakhala ndi chiopsezo cha kudya kwambiri.

Ndikulimbikitsidwa kuperekera mankhwalawa nthawi yomweyo, izi zithandiza kugwira ntchito kwa kapamba ndi m'mimba.

Mapiritsi amtundu wa 2 shuga a mellitus Januvia amatenga 100 mg kamodzi patsiku, mosasamala za chakudya. Nthawi yomweyo, akulangizidwa kuti muzimwa kuti zodzetsa pakati pakumwa ndizofanana. Mankhwalawa amalekeredwa bwino.

Chithandizo chimachitika pogwiritsa ntchito Januvius imodzi kapena osakanikirana ndi njira zina.

Kutenga mankhwalawa ngati mbali imodzi, odwala adakumana ndi chitukuko cha matenda a mtundu 1, omwe amakakamiza odwala kuti azigwiritsa ntchito insulin nthawi zonse asanadye.

Onglis amagwiritsidwa ntchito ngati monotherapy, maphunziro ophatikiza ndi mlingo wa 5 mg 1 nthawi patsiku.

M'badwo watsopano wa mankhwalawa amatengedwa 1 nthawi patsiku. Mlingo woyenera wophatikizidwa ndi 50 mg, osasamala chakudya. Kugwiritsa ntchito bwino kwa mapiritsi kumakhalabe tsiku lonse, komwe kumachepetsa kuyipa kwa Galvus pathupi lonse.

Zotsatira zoyipa, kukula kwa matenda amtundu 1 kumadziwika.

Kukonzekera komwe kwabwera chifukwa cha matenda ashuga amitundu iwiri amatha kupititsa patsogolo zotsatirazi ngati atengedwa limodzi ndi Siofor, Glucofage.

Mankhwala omwe amalimbikitsa chidwi cha khungu ku insulin

Mankhwala osokoneza bongo a shuga, thiazolidinediones (glitazones), mankhwala omwe amachititsa chidwi cha maselo kuti apangidwe ndi insulin, amatha kuyambitsa mavuto ambiri.

Mu shuga, kumwa mankhwala osokoneza bongo, odwala adakumana nawo:

ndi chiopsezo chowonjezeka cha mtima,
kutupa nthawi zambiri kumawonedwa.

Mwa akazi, mankhwala amawonjezera chiopsezo cha mafupa ndi mafupa. Mankhwalawa a shuga amatsutsana ngati:

wodwala ali ndi edema,
Zizindikiro zina zamkati wamtima.

Mankhwalawa amapangidwa m'mapiritsi, zomwe zimagwiritsidwa ntchito momwe mlingo wa 15-40 mg. Mlingo wa wodwala aliyense amasankhidwa mosiyanasiyana, poganizira kuchuluka kwa plasma glucose.

Kwenikweni, mankhwalawa amayamba ndi 15 mg, ndiye kuti muwonjezere mlingo. Sikulimbikitsidwa kugawana ndi kutafuna mapiritsi.

Imwani mankhwalawa pambuyo pake. Mlingo woyambirira umawonedwa kuti ndi 0,5 mg kamodzi patsiku. Lolani 0,87 mg kamodzi tsiku lililonse.

Kenako, sabata iliyonse, mlingo umakulirakulira mpaka umafikira 2-3 g.oletsedwa kutenga oposa 3 magalamu.

Mapiritsi a mankhwala amagwiritsidwa ntchito katatu patsiku. Dotolo amasankha muyeso wochokera pakuwunika magazi. Ndikotheka kutenga 50-100 mg ya mankhwala othandizira. Amamwa mankhwalawo pogwiritsa ntchito chakudya chachikulu.

Ntchito ya Glucobay imatha maola 8.

Kumayambiriro kwa mankhwalawa, kumwa piouno kamodzi pa tsiku ndi 15 mg. M'magawo, mlingo umakula ndikufika pa 45 mg. Amamwa mankhwalawa panthawi yoyamba ya chakudya nthawi yomweyo.

Kugwiritsa ntchito bwino kwa mankhwalawa kumatheka pothandizidwa ndi odwala matenda ashuga. Kulandila kulibe chakudya. Poyamba, amamwa 15-30 mg, ngati kuli kotheka, adotolo adzaonjezera mlingo mpaka 45 mg.

Nthawi zina mutatenga Astrozone, zotsatira zoyipa zimayamba, zimawonetsedwa ndi kuwonjezeka kwa thupi.

Kufotokozera ndi malangizo a mankhwala a Januvia

Pankhani ya mawonekedwe a kumasulidwa, Januvia ndi piritsi lozungulira wozungulira. Amadziwika ndi mtundu wotuwa wa pinki komanso mthunzi wa beige. Gawo lililonse limakhala ndi chizindikiro, 221, ngati kugwiritsidwa ntchito kwakukulu kuli 25 mg, 112 - 50 mg ndi 277 - 100 mg. Polankhula mwatsatanetsatane za mankhwala omwe mwaperekedwa, samalani ndi chidwi chakuti:

Chofunikira chachikulu ndi sitagliptin hydrophosphate,
othandizira agwiritsidwe ntchito ngati cellulose, calcium hydrogen phosphate, komanso magnesium stearate,
mowa wa polyvinyl, titanium dioksidi, macrogol ndi ziwiya zina zimakhazikika mgolo la mapiritsi.

Poona zomwe apolisi akuchita, samalani chifukwa chidacho chimakulitsa kuchuluka kwa mahomoni am'banja la impretin. Zomwe zimaperekedwa zimathandizira kapamba kuti apange gawo la mahomoni poyankha kudya, komanso amachepetsa kupanga glucagon.

Chifukwa cha izi, kuchuluka kwa shuga m'magazi kumacheperachepera popanda mwayi wa hypoglycemia. Januvia amuchotseredwa ndi impso limodzi ndi mkodzo ndi 80-90%, komanso chiwindi ndi 1020%.

Januvia ndi mankhwala omwe amachepetsa kuchuluka kwa shuga m'magazi a anthu. Yogwira pophika mankhwala ndi sitagliptin. Izi zimapangitsa enzyme DPP-4. Njira zoperekera zakudya zamatenda a metabolism m'thupi zimakhala zosiyanasiyana.

Januvia ndi ena incretinomimetics pa matenda a shuga

Januvia, Galvus, Victoza, Ongliza, Baeta ... Zachidziwikire kuti mumadziwa mayina awa a mankhwala, ndipo mwina ena mwa omwe amawerenga amawagwiritsa ntchito tsiku lililonse ngati kuphatikiza kapena monotherapy a matenda ashuga.

Ngati mukukumbukira, munkhani yokhudza zakudya zamagulu odwala pambuyo pa cholecystectomy, tidalonjeza kuti tidzayankhulana posachedwa za njira yatsopano yothandizira matenda ashuga, yomwe ikulowetsedwa mowonjezereka ndi endocrinologists tsiku lililonse.

Ndi za ma protein. Lero tiyesa kufotokoza mwatsatanetsatane momwe tingagwiritsire ntchito mankhwala ali mgululi, kufotokoza momwe amagwirira ntchito mopitilira muyeso, komanso kunena mawu owonjezera pazotsatira zina zabwino zomwe zimawonedwa zikagwiritsidwa ntchito.

Januvius, Galvus, Victoza ...

Nthawi zambiri, odwala amakhala ndi chidwi chofuna kuti ndi mankhwala ati omwe ali ndi incretinomimetic bwino? Zothandiza kwambiri ndi chiyani: Galvus, Baeta, Onglisa kapena Januvius? Tisanayankhe funso ili, tiyeni tiwone zomwe zimapanga ma protein. Ndipo kodi mankhwalawa amakwaniritsa bwanji mphamvu zawo?

Mwamwambo kuyitanitsa ma incretins mahomoni apadera omwe amapangidwa mu lumen ya m'mimba. Zinthu izi zimakulitsa kuchuluka kwa insulin m'magazi. Mu thupi la munthu, kapangidwe ka ma insretins amathandizira poyankha chakudya. Pali mitundu iwiri yayikulu ya "insretin" yomwe imadziwika.

Awa ndi HIP (glucose-insulinotropic polypeptide) ndi GLP-1 (glucagon-peptide-1). GLP-1 ili ndi zowonjezera zambiri kuposa ma GUI.

Ndipo izi zikuchitika chifukwa chakuti GLP-1 imatha kukhudza ziwalo ndi ma cell osiyanasiyana poganizira kukhalapo kwa “khadi yantchito yambiri” - ma receptor ake amwazika thupi lonse, pomwe ma HIP receptors amangopezeka pamaselo a pancreatic beta zotupa.

Chifukwa chake zotsatira za HIP ndizokhazo zomwe zimapangitsa kuti inshuwaransi ikhale ndi mphamvu yolimbitsa thupi poyankha chakudya, ndipo zotsatira za GLP-1 ndizosiyana kwambiri. Timalemba mndandanda waukulu: Kutsegula kapangidwe ka insulin. Monga tafotokozera pamwambapa, kuwonjezeka kwa kupanga ma impretin kumachitika ndi chakudya.

Kuphatikiza apo, kukondoweza kwa kupangika kwa insulin ndi ma insretins kumayendetsedwa ndi chiwonetsero cha glycemia. Pa mulingo wamagazi pamwamba pa 5-5,5 mmol / L, kutulutsidwa kwa insulin kumayendetsedwa. Ndipo pambuyo pa standardoglycemia, ma insretins amasiya kuyambitsa insulin.

Chifukwa cha mawonekedwe amtunduwu wa ma insretins, palibe kuchepa kwakukulu kwa shuga wamagazi ndi kukula kwa zizindikiro za hypoglycemia. Kuletsa kwa kaphatikizidwe ka glucagon. Glucagon ndi wotsutsa insulin. Kupanga kwake kumachitika m'maselo a alpha a kapamba.

Likukhalira kuti zoterezi za GLP-1 (zoletsa shuga) zimathandizanso kuti shuga azikhala bwino, zomwe zimalepheretsa shuga kutulutsa chiwindi. Kuponderezedwa kwa chilakolako champhamvu chotsogozedwa ndi GLP-1 kumayenderana ndi kuthana kwake kwachindunji pakukwaniritsidwa ndi njala, yomwe ili pamalo apamwamba - hypothalamus.

Mankhwala osakanikirana

Mokhazikika, mankhwala othandizira odwala matenda a shuga amatha kugawidwa m'magulu angapo, kutengera cholinga chawo komanso momwe thupi lawo limagwirira ntchito:

zomwe zimapangitsa kuti chiwonetsero cha cell chiwonjezeke kwambiri,
mankhwala othandizira kapamba
mankhwala omwe amalimbikitsa kuchuluka kwa insulin m'magazi a wodwala,
mankhwala osokoneza bongo.

Nthawi zambiri, mtundu wachiwiri wa matenda ashuga ndi matenda omwe amapezeka ndipo amapezeka mwa okalamba. Odwala safuna jakisoni wa insulin tsiku ndi tsiku, ndipo maziko a mankhwalawo ndi chakudya chapadera komanso njira zingapo zochizira kunenepa, chifukwa kunenepa kwambiri komwe kumayambitsa chitukuko cha matenda ashuga.

Chakudyacho chimafunikira kukhalabe ndi shuga m'magazi ndipo, ndi njira yoyenera, chimasokoneza kudumpha mu ndende ya glucose. Zosankha zimasankhidwa kutengera zosowa za thupi.

Kudya calorie tsiku ndi tsiku kumayendetsedwa bwino kuti muchepetse kunenepa. Chithandizo chotere chimapangidwira pang'onopang'ono (popanda kulumpha mwadzidzidzi) kuwonda, motero nthawi zambiri imathandizidwa ndi masewera olimbitsa thupi apadera.

Chimodzi mwazomwe zachitika posintha momwe wodwala alili ndi matenda a shuga a 2 ndi mankhwala a Januvia, Yanumet, Galvus Met ndi Galvus. Amapezeka mwanjira ya mapiritsi, chifukwa chake ndi otchuka kwambiri pakati pa odwala chifukwa cha njira yosavuta yotulutsira.

Mapiritsi amathandizira kapamba kuti azitha kutulutsa insulin, amathandizira kuchepetsa kuchuluka kwa shuga m'magazi. Masiku ano, Januvia ndi Galvus amatengedwa ngati mankhwala othandiza kwambiri pochiza matenda a shuga a mtundu wachiwiri.

Januvia amapezeka pamapiritsi osiyanasiyana. Mulingo watsiku ndi tsiku amasankhidwa poganizira momwe matendawo akutsikira, koma nthawi zambiri amakhala 100 mg wa mankhwala patsiku. Monga lamulo, mapiritsi amatengedwa nthawi 1 patsiku, mankhwalawa amayamba kugwira ntchito pambuyo pa theka la ola, ndipo zochita zake zimakhala kwa tsiku limodzi.

Januvia amaletsa kukula kwa glycemia mu matenda a shuga, chifukwa chake nthawi zambiri amalembedwa kuwonjezera pa zakudya ndi masewera olimbitsa thupi.

Zomwe zimagwiritsidwa ntchito ndi mapiritsi a Galvus ndi vildagliptin, mankhwala omwe amapezeka pamankhwala ndi ofanana ndi mphamvu ya mankhwala a Januvia.

Galvus imapezekanso m'mapiritsi ndipo itha kugwiritsidwa ntchito ngati monotherapy kapena ngati cholumikizira chithandizo chokwanira cha matenda ashuga.

Ubwino wa mankhwalawa ndi kusowa kwa glycemia, yomwe nthawi zambiri imawonedwa pakumwa ndi othandizira ena kuti apangitse ntchito ya pancreatic.

Ngati chithandizo chachikhalidwe sichitha, ndipo chithandizo ndi Yanuviya kapena Galvus sichimabweretsa zotsatira zowoneka, kukonzekera kovuta kumayikidwa.

kutsitsa shuga
kutsekereza enzyme DPP-4,
kukonza insulin katulutsidwe.

Kwa izi, mankhwala ovuta omwe ali ndi metformin ndi omwe amapatsidwa.M'mafamu, mungapeze mankhwala osakanikirana a Galvus Met ndi Yanumet. Mawu akuti "meth" m'dzina la mapiritsi awa akuwonetsa zomwe zili metformin.

Kugwiritsa ntchito mankhwala ophatikiza kumapereka zotsatira zabwino, kusintha kwakukulu pamikhalidwe ya wodwalayo kumawonedwa patatha masiku ochepa atamwa mankhwalawo.

Monga lamulo, Janumet ndi Galvus Met adayikidwa ngati wodwala wokalamba. Zoyenera kugula - Galvus Met kapena Yanumet, yomwe imagwira ntchito bwino komanso yomwe imatsimikiziridwa bwino ndi dokotala, potengera mawonekedwe a maphunziro a shuga mwa wodwala wina.

Pophunzira za momwe mankhwalawa amachitikira ndi mankhwala ena, sitagliptin alibe mphamvu kwambiri pa pharmacokinetics ya mankhwala monga Metformin, Rosiglitazone, Glibenclamide. Zomwezi zimagwiranso ntchito pakuletsa pakamwa. Akatswiri amalipira chidwi chakuti:

kuchuluka kwakukulu kwa AUC (11%) kunazindikiridwa, komanso kutentha kwapakati pa Digoxin mukamagwiritsidwa ntchito limodzi ndi sitagliptin. Kuchulukitsa komwe kwaperekedwa sikofunika kwambiri pakliniki
sikulimbikitsidwa kuti musinthe mlingo wa Digoxin kapena Januvia pogwiritsa ntchito munthawi yomweyo,
adazindikira kuwonjezeka kwa zochita za sitagliptin kwa odwala omwe amagwiritsidwa ntchito limodzi ndi Januvia limodzi mlingo wa 100 mg. Zomwezi zimagwiranso ntchito pa cyclosporine (imodzi mwa zoletsa zamphamvu kwambiri za P-glycoprotein) pazowerengeka chimodzi za 600 mg,
Kusintha kwa mankhwala a cellgokinetic a sitagliptin omwe aperekedwa pano sikuyenera kuwonedwa kuti ndi ofunika malinga ndi mawonedwe azachipatala.

Kusintha kwa muyezo wa Januvia kuti mugwiritse ntchito kamodzi ndi cyclosporine ndi zina za P-glycoprotein inhibitors (mwachitsanzo, Ketoconazole) sikulimbikitsidwa. Chisamaliro chapadera chiyenera kuperekedwa kwa fanizo la mankhwala omwe aperekedwa.

Januvia ndi mankhwala ofala kwambiri mdziko lathu komanso akunja (ma analogues) omwe madokotala ambiri amalamula kuti azichiza matenda ashuga a 2. Zotsatira zazikulu zomwe mankhwalawa ali nazo ndikupanga kusintha kwa shuga.

Mankhwalawa nthawi zambiri amakhala ophatikiza mankhwala. Metformin kapena PPAR agonists amalembedwera limodzi nawo ngati physiotherapy yophatikiza ndi monotherapy singapereke zotsatira zabwino zamankhwala.

Kumwa mankhwalawa kumalimbikitsidwa kwa odwala onse omwe ali ndi matenda a shuga a 2, ngati alibe zotsutsana. Monga lamulo, 100 mg imakhazikitsidwa kamodzi patsiku ngati monotherapy, kapena kuphatikiza ndi PPAR agonist kapena metformin.

Masiku ano, pali mitundu yambiri ya mankhwala a shuga, koma si onse omwe amagwira ntchito mofananamo komanso otetezeka ku thanzi. Madokotala amatcha "Januvia" imodzi mwa mankhwala otetezeka komanso othandiza kwambiri ndipo nthawi zambiri amalimbikitsa kugwiritsa ntchito mankhwalawa.

Kufotokozera za mankhwala Januvia

Mankhwala osokoneza bongo ndi mapiritsi a bulangeti yamafilimu a beige, pinki kapena opepuka a 50 mg kapena 100 mg.

Mankhwala tikulimbikitsidwa kuti adzatengedwa molumikizana ndi masewera olimbitsa thupi komanso zakudya kuti shuga izikhala ndi magazi. Imagwira ngakhale pa nthawi yomwe zakudya ndi masewera olimbitsa thupi sizipereka zotsatira zoyenera komanso kulola kuti glycemic idumphe.

Panthawi ya utsogoleri, kuwonjezeka pang'ono kwa kuchuluka kwa uric acid, kuchuluka kwa leukocytes, ndizotheka. Kusintha konseku mu thupi ndi thanzi pamene mukumwa mankhwalawo sikunazindikiridwe kukhala kofunika kwambiri m'chipatala.

Mlingo waukulu - 800 mg patsiku - anali wolekeredwa bwino ndi odwala omwe ali mgululi; kusintha kwakukulu pazizindikiro zofunika sikunawonedwe.

Kuphatikiza kwa Januvia ndi mankhwala ena kwaphunziridwa kwa nthawi yayitali. Zakhazikitsidwa kuti mapiritsi amatha kumwa mosamala nthawi yomweyo ndi metformin, warfarin, rosiglitazone, glibenclamide, kulera kwamlomo, etc. Mutha kupeza mndandanda wonse pamalangizo.

Mulimonsemo, muyenera kufunsa dokotala musanayambe kumwa mankhwala awiri nthawi imodzi.

Mlingo ndi makonzedwe

Mukamachita monotherapy, Januvia angagwiritsidwe ntchito ngati kuwonjezera pa zakudya komanso masewera olimbitsa thupi. Izi zikuthandizira kuwongolera kwa matenda a shuga a mtundu wa 2.

Pankhani ya kuphatikiza chithandizo, chidwi chimaperekedwa pakugwiritsa ntchito kapangidwe kake kuti athandize kusintha kwa glycemic control kuphatikiza ndi metformin kapena PPAR-γ agonists (mwachitsanzo, thiazolidinedione). Kuphatikiza apo, izi ndizofunikira ngati chakudya komanso masewera olimbitsa thupi osakanikirana ndi monotherapy ndi mayina omwe aperekedwa samatsogolera ku chiwongolero cholondola cha glycemia.

Kutsutsana pa ntchito ya Januvia kuyenera kuwonedwa ngati gawo lowonjezereka la magawo a zinthu. Komanso samalani ndi:

lembani matenda a shuga 1 mellitus (mawonekedwe a insulin)
matenda ashuga ketoacidosis,
mimba
nthawi yoyamwitsa.

Malamulo ngati ana ndi achinyamata osakwana zaka 18 sayenera kuyang'aniridwa. Izi ndichifukwa choti palibe deta yokhudza kugwiritsa ntchito mankhwalawa machitidwe a ana.

Mosamala, Januvia iyenera kugwiritsidwa ntchito mosazungulira mpaka pakukanika kwambiri kwaimpso. Kuphatikiza apo, izi zimagwira ntchito kwa odwala omwe ali ndi vuto la aimpso otsiriza, omwe amafunikira hemodialysis, ndipo akuyenera kusintha dongosolo.

Januvia angagwiritsidwe ntchito kokha mkati.

Ngati mugwiritsidwa ntchito ngati monotherapy kapena molumikizana ndi metformin, thiazolidinedione, ndi ena agonists a PPAR-γ, mulingo woyenera ukhale 100 mg kamodzi pa maola 24 aliwonse.

• Monotherapy.

Januvia akuwonetsedwa ngati cholowera pakudya ndi kuchita masewera olimbitsa thupi kuti alimbikitse kuwongolera kwa glycemic kwa odwala omwe ali ndi matenda a shuga a 2. • Kuphatikiza mankhwala.

Januvia amasonyezedwanso kwa odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe amawongolera kusintha kwa glycemic kuphatikiza ndi metformin kapena agonists a PPAR? (mwachitsanzo, thiazolidinedione), kudya komanso kuchita masewera olimbitsa thupi kuphatikiza ndi monotherapy ndi mankhwala omwe atchulidwa sikuti kumabweretsa chiwongolero chokwanira cha glycemia.

Mlingo wovomerezeka wa Januvia ndi 100 mg kamodzi tsiku lililonse ngati monotherapy kapena kuphatikiza ndi metformin kapena agonist wa PPAR? (mwachitsanzo, thiazolidinedione).

Mankhwalawa akhoza kumwedwa mosasamala chakudyacho.

Wodwala akaphonya mankhwalawo, ayenera kumwa mosamala kwambiri akakumbukira mankhwala omwe adaphonya.

Osalola kawiri mlingo wa Januvia.

Odwala ofooka aimpso kulephera sikufuna kusintha kwa mlingo.

Kwa odwala omwe amalephera kupezeka aimpso, Mlingo wa mankhwalawa ndi 50 mg 1 nthawi patsiku.

Kwa odwala omwe ali ndi vuto lalikulu la impso, komanso ndi gawo logona la matenda a impso omwe amafunikira hemodialysis, mlingo wa mankhwalawa ndi 25 mg 1 nthawi patsiku.

Mankhwala angagwiritsidwe ntchito mosasamala ndondomeko ya hemodialysis.

Palibe kusintha kwa mlingo kumene kwa odwala okalamba.

Ngati wodwala wapezeka ndi matenda a shuga, ndiye muyenera kufunsa dokotala yemwe angakupatseni Januvia mwapadera. Wopanga amawonetsa mlingo, poganizira kugwiritsa ntchito mankhwalawa molumikizana ndi othandizira ena. Wodwalayo amamwa mapiritsi nthawi iliyonse, ngakhale atakhala kuti amadya. Ikani mankhwala zochuluka motere:

Kulephera kwa impso kulephera mawonekedwe sikutanthauza kusintha kwa mlingo.
Kuwonetsa moyenera kufooka kwa impso kumaphatikizapo kudya kwa 50 mg ya mankhwala tsiku lililonse.
Kuchepa kwambiri kwa impso kapena kufunika kwa hemodialysis kumapangitsa wodwala kumwa 25 mg tsiku lililonse tsiku lililonse.

Ndi zoletsedwa kugwiritsa ntchito "Januvia" muyezo wapawiri, izi zitha kubweretsa mavuto.

Zizindikiro zogwiritsidwa ntchito

Hypersensitivity ku zilizonse za mankhwala, pakati, nthawi yoyamwitsa, mtundu 1 shuga mellitus, matenda ashuga ketoacidosis.

Kugwiritsa ntchito kwa Januvia muzochita za ana mwa odwala ochepera zaka 18 sikulimbikitsidwa.

Odwala omwe ali ndi kuchepa kwapakati komanso mwamphamvu aimpso, komanso odwala omwe ali ndi vuto laimpso omwe amafunikira hemodialysis, kusintha kwa mankhwala kumafunika.