Mapiritsi a Onglisa a shuga

Ndi kukula kwa shuga osadalira insulin, odwala satha nthawi zonse kuwongolera kuchuluka kwa glycemia pogwiritsa ntchito zakudya zapadera komanso masewera olimbitsa thupi. Onglisa ndi mankhwala ochepetsa shuga omwe amagwiritsidwa ntchito mwanjira imeneyi kukhazikitsa kuchuluka kwa shuga m'magazi.

Monga mankhwala aliwonse, Onglisa ali ndi zotsutsana, zochita zoyipa, komanso mawonekedwe ogwiritsira ntchito. Chifukwa chake, musanagwiritse ntchito mankhwalawa, muyenera kudziwa zambiri za mankhwalawo.

Onglisa (mu lat. Onglyza) ndi mankhwala odziwika bwino omwe amagwiritsidwa ntchito padziko lonse lapansi matenda ashuga a 2. Dzinalo losafunikira ladziko lonse (INN) la mankhwalawa ndi Saxagliptin.

Wopanga wothandizila wa hypoglycemic ndi kampani yaku America ya mankhwala a Bristol-Myers squibb. Gawo lalikulu - saxagliptin amadziwika kuti ndi imodzi mwazosankha zamphamvu kwambiri zosakanikirana za dipeptidyl peptidase-4 (DPP-4). Izi zikutanthauza kuti mankhwalawa akamwa pakamwa, chinthu chachikulu chimachepetsa mphamvu ya enzyme ya DPP-4 masana.

Kuphatikiza pa saxagliptin, mapiritsi a Onglis ali ndi zochepa zowonjezera - lactose monohydrate, croscarmellose sodium, microcrystalline cellulose, macrogol, talc, titanium dioxide, magnesium stearate ndi ena ambiri. Kutengera mtundu wa kumasulidwa, piritsi limodzi la mankhwalawa limatha kukhala ndi 2.5 kapena 5 mg ya chinthu chomwe chikugwira ntchito.

Kodi wothandizila wodwala matenda a shuga Akuma amatha bwanji atalowa m'thupi la munthu? Saxagliptin imalowa mwachangu m'mimba, zomwe zimapezeka kwambiri m'madzi a m'magazi zimawonedwa patatha maola 2-4 mutatha kuzigwiritsa ntchito. Mankhwala ali ndi zotsatirazi:

1. Kuchulukitsa mulingo wa ISU ndi GLP-1.
2. Amachepetsa zomwe zili ndi glucagon, komanso zimathandizira momwe maselo a beta, omwe amaphatikizira kuwonjezeka kwa C-peptides ndi insulin.
3. Zimakwiyitsa kumasulidwa kwa timadzi totsitsa-shuga ndi ma cell a beta omwe amapezeka m'matumbo.
4. Imaletsa kumasulidwa kwa glucagon ku ma alpha cell a islets a Langerhans.

Pakuwonjezera njira zomwe zili pamwambapa, mankhwala a Onglis amasintha mphamvu za glycated hemoglobin (HbA1c), zizindikiro za shuga pamimba yopanda kanthu ndikatha kudya. Madokotala amatha kupereka mankhwalawa limodzi ndi othandizira ena a hypoglycemic (metformin, glibenclamide kapena thiazolidinediones).

Chidacho chimachotsedwa m'thupi m'njira yosasinthika komanso mawonekedwe a metabolite ndi bile ndi mkodzo.

Pafupipafupi, chiwonetsero cha impso cha saxagliptin ndi 230 ml pamphindi, ndipo kuchuluka kwa kusefedwa kwa glomerular (GFR) ndi 120 ml pamphindi.

Malangizo ogwiritsira ntchito mapiritsi

Asanayambe kumwa mankhwalawa, wodwalayo ayenera kufunsa odziwa ntchito yake yazaumoyo omwe angadziwe kuchuluka kwake malinga ndi shuga. Pogula mankhwalawa Onglisa, malangizo ogwiritsira ntchito ayenera kuwerengedwa mosamala ndipo ngati muli ndi mafunso mufunse adokotala.

Mapiritsi amagwiritsidwa ntchito mosasamala nthawi yakudya, osambitsidwa ndi kapu yamadzi. Ngati mankhwalawa amatengedwa ngati monotherapy, ndiye kuti tsiku lililonse mlingo 5 mg. Ngati dokotala atakupatsani mankhwala othandizira, ndiye kuti tsiku limaloledwa kugwiritsa ntchito Onglisa amatanthauza 5 mg ndi metformin, thiazolidinediones ndi mankhwala ena a hypoglycemic.

Kuphatikiza Onglisa ndi metformin, muyenera kutsatira mlingo woyambirira wa 5 mg ndi 500 mg, motsatana. Ndi zoletsedwa kumwa mitundu iwiri panthawi yomwe wodwalayo atayiwala kumwa mankhwalawa panthawi. Akakumbukira izi, ayenera kumwa piritsi limodzi.

Makamaka makamaka ndi odwala omwe ali ndi vuto la impso. Ndi mawonekedwe ofatsa aimpso, sikofunikira kusintha mlingo wa mankhwalawa. Odwala omwe ali ndi kuchepa kwapakati kapena kwambiri aimpso, komanso omwe akudwala hemodialysis, mlingo wa tsiku ndi tsiku ndi 2.5 mg. Kuphatikiza apo, mukamagwiritsa ntchito CYP 3A4 / 5 zoletsa, mlingo wa mankhwala a Onglis uyenera kukhala wochepa (2,5 mg).

Wopanga akuwonetsa pa phukusi tsiku lotha ntchito, lomwe nthawi zambiri limakhala zaka zitatu. Mankhwalawa amasungidwa kutali ndi ana aang'ono pa kutentha kosaposa 30 digiri.

Zizindikiro zogwiritsidwa ntchito

Mtundu wachiwiri wa matenda ashuga, chiwopsezo cha maselo ku glucose amachepetsa kwambiri. Pakadali pano, pali kuchedwa mu gawo loyamba la kuphatikiza kwa mahomoni.

Mtsogolomo, gawo lachiwiri limatayika chifukwa chosowa ma insretin. Kuchepetsa kwa chiwonetsero cha enzyme DPP 4, ma insretin amakhala nthawi yayitali m'magazi, insulin yambiri imapangidwa. Glycemia pamimba yopanda kanthu komanso yodzaza imakonzedwa, kugwira ntchito kwa kapamba kumabwezeretsedwa. Chifukwa chake, Onglisa amawonjezera ntchito ya mahomoni awoawo, amawonjezera zomwe ali.

Mankhwala Onglisa okhala ndi matenda a shuga a 2 (kuwonjezera pa zakudya zoyenera ndi masewera) amasonyezedwa monga:

• mankhwala oyamba ndimankhwala angapo, limodzi ndi metformin,
• mankhwala othandizira ndi metformin, insulin, zotumphukira za sulfonylurea,
• monotherapy.

Kugwiritsa ntchito Onglises kumapangitsa kuti glycemic control.

Kutulutsa Fomu

Dziko loyambira - USA, koma mapiritsi okonzedwa okonzeka akhoza kuikidwa mu UK kapena Italy.

Amapangidwa mwanjira ya mapiritsi ozungulira, ma convex mbali zonse ziwiri, mbali yakunja ndi yokutira. Piritsi lililonse lili ndi manambala amtambo. Mtundu wa Onglisa umatengera kuchuluka kwa zinthu zomwe zimagwira: 2.5 mg iliyonse ndi maso achikasu achikasu ("2,5" amalembedwa mbali imodzi, "4214" amalembedwa mbali inayo), ndipo 5 mg iliyonse ndi yapinki (manambala “5” ndi “4215 ").

Mapiritsiwo amakhala m'matumba opangidwa ndi zojambulazo: m'matumba amodzi 3 matuza a zidutswa 10. Chodzaza chilichonse chimakhala ndi mafuta omwe amagawa magawo 10 (mwa kuchuluka kwa mapiritsi). Katemera wa makatoni amatetezedwa kuti asasokonekera ndi zomata zowoneka bwino zomwe zimawonetsa mauna achikasu.

Mutha kugula mankhwala a shuga Onglizu m'masitolo ogulitsa. Mankhwala omwe akupezeka, koma si onse azachipatala omwe amatsata lamuloli. Mu 2015, mankhwalawo adaphatikizidwa pamndandanda wazofunikira, kotero ngati wodwala matenda ashuga adalembetsa, akhoza kuupeza kwaulere.

Pafupipafupi, mtengo wokumangira mapiritsi 30 ndi pafupifupi 1800 rubles. Sungani mankhwalawo pa kutentha kosachepera 30 madigiri kutali ndi ana. Kusungirako sikuyenera kupitirira zaka zitatu.

Chomwe chimagwira ndi saxagliptin hydrochloride (2,5 kapena 5 mg). Uwu ndi woyimira wa inhibitor wamakono wa DPP-4.

Othandizira ndi:

• MCC
• lactose monohydrate,
• sodium croscarmellose,
• magnesium wakuba,
• hydrochloric acid
• utoto.

Gawo lakunja la piritsi limakhala ndi utoto wa OpadryII.

Zolemba zogwiritsira ntchito

Pa gawo loyamba la kusintha kwa impso, palibe chifukwa chosinthira. Pamavuto akulu kwambiri, hemodialysis, mlingo woyenera wa mankhwala a Ongliza ndi 2.5 mg patsiku. Mankhwalawa amalimbikitsidwa kuti aperekedwe njira yakuyeretsa magazi ikatha. Pamaso pathu ndi chithandizo, ndikofunikira kuwunika momwe impso zimayambira.

Zotsatira za Onglises pa thupi ndi njira yodziwira kuyeretsa magazi sizinafufuzidwe.

Kusintha kwa ntchito ya chiwindi, mosasamala za kuopsa, sikofunikira kusintha kamodzi.

Zotsatira zakugwiritsa ntchito kwa Onglisa mu odwala matenda ashuga oposa 65 ndizofanana ndi zomwe zimachitika kwa odwala achichepere. Mukakalamba, muyenera kumwa nthawi zonse. Ndikofunikira kukumbukira kuti pa nthawi iyi ya chitukuko, kugwira ntchito kwa impso kumachepa, gawo lomwe likugwira ntchito mokwanira linawatulukira.

Palibe chidziwitso chazakuwopsa ndi zotsatira zoyipa za Onglisa osakwanitsa zaka 18.

Kugwirizana kwa Onglisa ndi insulin panthawi yamankhwala sikunafufuzidwe. Palibe deta pazomwe zimagwiritsa ntchito mankhwalawa poyendetsa komanso zochitika ndi makina osinthika. Chizungulire zitha kuchitika pambuyo kumwa mankhwalawo.

Zokhudza zomwe zimagwira thupi la mayi wapakati komanso mkaka wake sizinaphunzire. Palibe chidziwitso kuti ngati chinthu chomwe chikugwiracho chikutha kulowa m'chiberekero ndi kupita mkaka wa m'mawere, ndiye kuti mankhwalawa sanalembedwe nthawi ino. Ngati sikotheka kupewa kugwiritsa ntchito Onglisa, panthawi yomwe mumamwa mankhwalawa, kuyamwitsa kumayima. Pankhaniyi, kuopsa kwa mwana komanso zovuta zomwe zingachitike kwa mayi zimaganiziridwa.

Sulfonylurea zotumphukira kwambiri amachepetsa shuga. Kupewa matenda amtunduwu limodzi ndi Onglisa, ndikofunikira kuti muchepetse mlingo wa sulfonylurea kapena insulin.

Pokhala ndi mbiri yakuwunika kwakukulu kwa odwala matenda ashuga (kuphatikizapo momwe thupi limagwirira ndi Quincke's edema), Ongliza sagwiritsidwa ntchito pakugwiritsa ntchito zoletsa zina za DPP-4. Ndikofunikira kuzindikira zomwe zimayambitsa hypersensitivity ndikuwonetsa njira zina zochizira (analogues za mankhwala Onglisa).

Pali umboni wa kapamba pachimake ndi kugwiritsa ntchito mankhwalawa. Odwala ayenera kudziwitsidwa zamtunduwu popereka Onglisa. Ngati mukuwoneka kuti mukuwonetsedwa kwa zizindikiro zoyambirira za kapamba, mankhwalawa amachotsedwa.

Mapiritsiwo ali ndi lactose, chifukwa chake, odwala matenda ashuga okhala ndi chibadwa cha galactose tsankho, kuchepa kwa lactase sikungatenge Onglisa.

Kuchita ndi mankhwala ena

Chithandizo choyambirira ndi metformin pakufunika kwa kusintha kwa moyo. Ngati chithandizo chotere sichikubweretsa zotsatira zoyembekezeredwa, mankhwala ena ovomerezeka amayamba.

Kafukufuku wachitika omwe akuwonetsa kuti pali chiopsezo chochepa cha kuphatikiza kwa saxagliptin ndi mankhwala ena.

Kugwiritsa ntchito palimodzi ndi ma inducers a CYP 3A4 / 5 isoenzymes kumathandiza kuchepetsa zomwe zili mu saxagliptin metabolic product.

Kutenga mankhwala a sulfonylurea kumachepetsa kwambiri kuchuluka kwa shuga m'magazi. Kuti mupewe chiopsezo chotere, ndikofunikira kuti muchepetse mlingo wa mankhwala Onglisa.

Palibe maphunziro omwe adachitika pazotsatira za kusuta, kudya, kapena kumwa mowa pa saxagliptin.

Njira zopewera

Onglisa ndi mankhwala otetezeka, zotsatira zosakonzekera sizimachitika. Pali zinthu zambiri zoyipa zomwe zimachitika ndi saxagliptin monga chithandizo cha placebo.

Kugwiritsa ntchito Onglises ndizoletsedwa pomwe:

• mtundu 1 shuga
• mogwirizana ndi insulin
• kuchepa kwa mkaka,
• matenda ashuga ketoacidosis,
• mimba
• yoyamwitsa
• wosakwana zaka 18
• kusalolera kwa chimodzi mwazigawo za mankhwala.

Ndikofunikira kuti odwala azigwiritsa ntchito:

• akuvutika kwambiri ndi vuto laimpso kapena chifuwa chachikulu m'mbuyomu,
• okalamba
• kugwiritsa ntchito munthawi yomweyo ndi sulfonylureas.

Mu chithandizo cha Onglisa, pamakhala zovuta zina:

• matenda a kwamkodzo thirakiti
• chapamwamba kupuma thirakiti matenda
• kutupa kwa sinus mucosa,
• kutupa kwam'mimba ndi matumbo aang'ono,
• akukumbutsa
• pachimake kapamba
• migraines.

Ndi mankhwala osakanikirana ndi metformin, nasopharyngitis imadziwonekera nthawi zina.

Hypersensitivity idadziwika mu 1.5% yamilandu, sinaopseze moyo, ndipo kuchipatala sikunafunike.

Mukamayikidwa limodzi ndi thiazolidinediones, kuweruza ndi kuwunika kwa Onglise, kupezeka kwa edema yofowoka kapena yapakati kunadziwika, komwe sikunafunike kutha kwa chithandizo.

Zovuta za hypoglycemia panthawi ya chithandizo ndi Ongliza zinali zogwirizana ndi zotsatira zake ndi placebo.

Bongo

Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, zizindikiro za poizoni sizifotokozedwa. Pankhani ya bongo, Zizindikiro ziyenera kutsitsimuka. The yogwira thunthu ndi kagayidwe kachakudya mankhwala amuchotsa ndi hemodialysis.

Analogs Onglises okhala ndi zinthu zomwezi omwe mulibe. Ili ndiye mankhwala okhawo omwe ali ndi saxagliptin. Zofanana pa thupi zimaphatikizidwa ndi Nesin, Trigueent, Galvus. Sizoletsedwa kugwiritsa ntchito analogi za Ongliz popanda chilolezo cha adokotala.

Mankhwala a shuga a Onglis amathandizira kuti magazi a shuga aziwongolera. Mapiritsi ndiosavuta kutenga. Ndikutha kuwona mwayi womwe sindinawone zotsatira zoyipa. Mwa maminiti, nditha kutchula mayina ochulukirachulukira.

Ndimakonda mankhwala Onglisa, pali malangizo omveka bwino ogwiritsa ntchito, ndi osavuta kugwiritsa ntchito. Nthawi zina mutu wochepa. Ndikupangira mankhwalawa.

Chithandizo cha Ongliza ndikuyimira gulu latsopano la mankhwala ochepetsa shuga. Ili ndi njira yosinthira mosiyanasiyana, koma mwanjira yofananira imafanana ndi mankhwala achikhalidwe, ndipo pachitetezo imapambana. Mankhwalawa ali ndi zotsatira zabwino pa matenda oyanjana, amalepheretsa kukula kwa shuga komanso zovuta zina.

Ubwino wosakayikiridwa ndi kusapezeka kwa chiwopsezo cha hypoglycemia, zimakhudza kulemera kwa wodwala komanso mwayi wogwiritsa ntchito mankhwala ena ochepetsa shuga. M'tsogolomu, asayansi akufuna kupanga mankhwala omwe adzabwezeretsenso chida cha pancreatic kwa nthawi yayitali.

Zotsatira za pharmacological

Mankhwala Onglisa mu kapangidwe kameneka ali ndi mankhwala ogwiritsa ntchito saxagliptin, omwe ndi osankha kwambiri omwe angathe kusinthanitsa ndi inhibitor ya dipeptidyl peptidase-4.

Ngati mankhwalawa amatengedwa ndi odwala omwe akudwala matenda ashuga, amakhala ndi zochitika kwa maola 24 enzyme DPP-4 imaponderezedwa.

Wodwala atatha kudya shuga mkati, chifukwa cha kuletsa kwa DPP-4, kuwonjezeka kwapawiri kwa ndende ya glucose-insulinotropic polypeptide, glucagon-peptide-1, kumachitika. Kuphatikizika kwa glucagon kumachepetsedwa ndikuyankha kwa ma cell a beta omwe amadalira glucose kumatheka. Zotsatira zake, kukhazikika kwa thupi kumawonjezeka insulin ndi C peptide.

Chifukwa cha kutulutsidwa kwa insulin ndi maselo a pancreatic beta komanso kuchepa kwa kutulutsidwa kwa glucagon kuchokera ku maselo a pancreatic alpha, kuchepa kwa glycemia, kuchepa postprandial glycemia.

Mukukonzekera saxagliptin odwala samapeza phindu lolemera.

Mankhwala ochepetsa shuga m'magazi a 2 shuga

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Mankhwala othandiza kuchepetsa shuga m'magazi amadziwika ndi madokotala, kutengera mtundu wa shuga wodwala amene ali nawo, gawo lake, komanso mkhalidwe wa odwala matenda ashuga. Kudziwapatsa nokha ndi owopsa kwambiri, chifukwa, ngati atasankhidwa molakwika, amatha kukhala ndi zotsatira zoyipa mthupi. Kuphatikiza apo, njira zosiyanasiyana zimagwiritsidwa ntchito kutsitsa shuga, zosiyana pakapangidwe ndi mtundu wa zochita. Pazifukwa izi, mankhwala omwewo omwe amachepetsa shuga m'magazi, nthawi imodzi amachitapo kanthu mwachangu, ndipo inayo alibe mphamvu.

• Insulin Gululi limaphatikizapo mankhwala okhawo, insulin yokha. Amalandira makamaka mtundu 1 wa shuga. Ndikofunikira kuti m'malo mwa zinthu zachilengedwe zomwe kapamba walephera kupanga. Palibe tanthauzo kugwiritsa ntchito kulipirira matenda a shuga a 2.Kutha kutsitsa shuga wamagazi mwanjira,
• Glucose digestibility blockers. Mankhwalawa ochepetsa shuga a magazi salola kuti glucose amwe ndi kutsitsidwa m'magazi,
• Incretin - mankhwala othandiza omwe amachepetsa shuga amatha kuteteza maselo a beta,
• Alembi. Mankhwalawa amathandizira kupanga insulin yanu ndi maselo a beta kuti muchepetse shuga. Oikidwa mu shuga ya mtundu woyamba, pomwe si maselo onse a beta omwe amawonongeka. Pafupifupi silinalembedwe mu mtundu wachiwiri, pamene insulin imapangidwa nthawi zambiri, koma osamwetsa,
• Mapiritsi ochepetsa shuga amachepetsa kukana insulini. Amalembera mitundu 2 ya shuga kuti awonjezere kuthekera kwa kutulutsa insulin ndikusamutsa glucose m'maselo.

Mankhwala onse ochepetsa shuga ndi osiyanasiyana pamachitidwe. Ali ndi mikhalidwe yabwino komanso yoyipa. Dokotala wodziwa za endocrinologist amatha kusankha zomwe zingathandize kuchepetsa magazi, kukhala ndi zovuta zoyipa.

Kuchulukitsa kwa insulin

• Biguanides ndi mankhwala ochepetsa shuga monga Glukovazh, Sifor. Zotsika mtengo, kuchepetsa chiopsezo cha mtima, musakhudze kulemera, chotsani cholesterol yowonjezera. Komabe, zimayambitsa kusasangalala komanso zovuta zazing'ono kuchokera m'matumbo amtumbo (aliyense payekhapayekha). Chizindikiro - mtundu 2 shuga,
• Thiazolidinediones (Pioglitazone) amatha kuteteza maselo a beta, amachotsa cholesterol "yoyipa" m'thupi, ndipo amatha kuchepetsa chiopsezo cha zovuta pamtima.

Palinso mankhwala ena omwe amachepetsa shuga m'magazi a 2 shuga, owonjezera kapena osagwira ntchito. Mankhwalawa sagwiritsidwa ntchito ngati mtundu wa 1 ashuga. Chithandizo chokha kwa iwo ndi insulin.

Alembi

• Sulfururea ndiye mankhwala othandizira omwe amachepetsa shuga ya magazi, monga Glyclazide MV, Glipizide. Zinthu izi zomwe zimapezeka m'magazi akuluakulu zimakhala ndi zotsatira zake mwachangu, sizotsika mtengo, komanso zimateteza impso. Komabe, mukamamwa, muyenera kusamala, chifukwa mankhwalawa omwe amachepetsa kwambiri shuga m'magazi nthawi zina amalimbikitsa hypoglycemia,
• Meglitinides (Repaglinide) chitani zinthu mwachangu ndipo musalole kuti hyperglycemia ichitike mukatha kudya. Mankhwala ochepetsa shuga awa ndi amodzi mwa ochepa omwe ali oyenera kwa anthu omwe amadya zakudya zosafunikira.

Mankhwala ochepetsa shuga a gulu loyamba amatha kuthetsa ziphuphu, chifukwa chake, kulandira kwawo kuyenera kuvomerezedwa ndi adokotala.

Othandizira opretin

• Oyambitsa amakhala abwino chifukwa ali ndi chiopsezo chochepa cha hypoglycemia, alibe mphamvu pa thupi ndipo amatha kuteteza khungu la beta. Mankhwala ochepetsa shuga amenewa amagulitsidwa pansi pa mayina a Sitagliptin, Saksagliptin. Mankhwala oyamba a matenda ashuga, ngakhale amachepetsa shuga la magazi, amatha kuyambitsa kapamba. Kuphatikiza apo, ndizokwera mtengo kugwiritsa ntchito zoletsa matenda ashuga
• Pansi pa agonists amamvetsetsa mankhwala ochepetsa shuga monga Liraglutid ndi Exenatide. Zokwanira kwa iwo omwe akuyang'ana yankho la funso la chithandizo chiti chomwe chingathandize kuti achepetse thupi. Zomwe zimachepetsa kuthamanga kwa magazi komanso kuteteza maselo a beta. Chiwopsezo chochepa cha hypoglycemia.

Agonists ndi okwera mtengo kwambiri ndipo ali ndi zovuta zingapo. Sadzachepetsa shuga m'magazi mwachangu, zimatha kuyambitsa mavuto komanso zovuta m'matumbo, komanso zimatha kuthandizira kukulitsa kapamba.

Kuletsa kuyamwa kwa glucose

Pakadali pano, madokotala amangotenga mankhwala amodzi kuchokera pagululi - acarbose inhibitors. Mankhwalawa okhala ndi shuga wambiri m'thupi amalepheretsa kuyamwa kwa glucose, osakulitsa mwayi wokhala ndi hypoglycemia. Zotsatira zoyipa (makamaka zazikulu kwambiri) sizimakhalapo konse, chifukwa chithandizo cha mankhwala awa ndiotetezeka.

1. Sizikumveka bwino kuti mankhwalawa a shuga amakhudza bwanji mtima
2. Mapiritsi awa ochepetsa shuga m'magazi a shuga a 2 siothandiza kwenikweni.
3. Fotokozerani zovuta zam'mimba,
4. Ayenera kudyedwa katatu patsiku.

Monga chithandizo ndi mapiritsi ena, mankhwalawa amaletsedwa kwa amayi apakati komanso oyembekezera, anthu omwe ali ndi vuto lalikulu la matenda ashuga, impso ndi chiwindi, komanso matenda am'mimba.

Contraindication

• Biguanides - mankhwalawa kuti muchepetse shuga m'magazi a shuga amaletsedwa kupereka chiwindi, osamwa, oyembekezera,
• Pangamanga. Mapiritsi awa omwe amachepetsa shuga ya magazi sayenera kugwiritsidwa ntchito pa edema, mtima ndi vuto la chiwindi, komanso, limodzi ndi insulin. Koma ngakhale pakalibe matenda awa, mankhwalawa amachepetsa shuga amatha kubweretsa zotsatira za nkhata - kulemera, edema. Kuphatikiza apo, ndi okwera mtengo kwambiri,
• Kukonzekera kwa Sulfaurea. Mankhwala antipyretic sangathe kumwedwa ndi chiwindi kulephera, ketoacidosis, komanso pakati komanso kuyamwa. Amatha kuyambitsa hypoglycemia, chifukwa, chizolowezi chodumpha mu shuga, atengere mosamala,
• Meglitinides. Sizoletsedwa kutenga impso, chiwindi, kusowa kwa shuga, nthawi yomwe ali ndi pakati komanso pakudya. Amakhala ndi zovuta monga chiopsezo cha hypoglycemia.
• Ma Dhib-4 ma inhibitors ndi okwera mtengo kwambiri ndipo si wodwala aliyense amene angakwanitse. Amaletsedwa kuti agwiritse ntchito impso, chiwindi kulephera, kudyetsa ndi pakati, kubwezera,
• Peptide-1 receptor agonists sangagwiritsidwe ntchito kuchepetsa shuga m'magazi ndi kuyamwa, kuyembekezera mwana, kulephera kwa impso, kulephera kwa chiwindi, matenda osokoneza bongo omwe salipiridwa bwino.

Pamaso pa matenda a pancreatic komanso m'badwo wa insulin, mankhwala aliwonse amatengedwa pokhapokha malinga ndi dokotala. Mankhwala ena amachepetsa matendawa komanso ma cell a beta ndipo amatha kupangitsa kuti matendawa asinthidwe kukhala fomu yodalira insulin. Zina zimatha kuyambitsa insulin.

Mawonekedwe a phwando

Ambiri odwala matenda ashuga amadabwa momwe amachepetsa shuga mthupi moyenera komanso mwachangu. Izi zimatheka pokhapokha kuvomerezedwa komanso kumwa mankhwala okhazikika. Molondola, adotolo angakuthandizeni kudziwa zamomwe mungamwe mapiritsi a shuga ndimankhwala ena. Komabe, pali malamulo apadziko lonse olandirira ndalama zina. Gome ili pansipa likuwonetsa mndandanda wa mankhwala a shuga wamagazi ndi malamulo ovomerezeka.

Kuphatikiza kwa Mankhwala Osokoneza bongo

ZiphuphuKufikira 0.12 gZovomerezeka pambuyo mphindi 40. Nthawi yowonekera bwino ndi maola 8. Chiwerengero cha madyerero ndi kuchuluka kwake kwa mankhwalawa ndiudokotalaMaola 8 AmarilKufikira 0.008 gKugwiritsa ntchito pambuyo theka la ola, nthawi yodziwonetsa bwino maola 22. Tengani kamodzi patsikuMaola 24 BiguanidesSiofor, GlucophagusKufikira 2 gAmachita theka la ola pambuyo kutsata (ogwira - maola 5). Chiwerengero cha madyerero ndi kuchuluka kwake kwa mankhwalawa ndiudokotalaMaola 9 MeglitinidesNovonormKufikira 0.016 gAmachita theka la ola pambuyo kutsata (ogwira - maola 4). Ndikofunikira kumwa pafupipafupi kapena monga mankhwala owonjezeraMaola 6 Acarbose InhibitorsGlucobay

Mpaka 0,6 gNdi shuga wowonjezera wamagazi, mankhwalawa amayamba kuchita theka la ola. Kugwiritsa ntchito moyenera 14 - 24 maola. Yovomerezeka kuchokera 1 mpaka 2 pa tsiku malinga ndi endocrinologist komanso kutengera mlingoMaola 24 ThimangAktos, Diab Norm, Amalvia15, 30, 45 mg (wosankhidwa ndi dokotala)Kugwiritsa ntchito mpaka maola 16. Imwani piritsi limodzi tsiku lililonse.Maola 24 Peptide-1 receptor agonistsBaeta

5 kapena 10 mcg (muyezo wa jakisoni amasankhidwa ndi dokotala)Kugwiritsa ntchito mpaka maola 12. Amalandira kawiri kapena kamodzi patsiku malinga ndi endocrinologist komanso kutengera mlingoMaola 12 Victoza0.6 mg, 1.2 mg, 1,8 mgKugwiritsa ntchito bwino shuga mu thupi mpaka maola 20. Imwani kamodzi patsiku.Maola 24 DPP ZoletsaTrazhenta, Januvius, OnglisaMpaka 5 mg (Januvia - mpaka 100 mg)Kulandila kamodzi patsiku kuti muchepetse shuga la magazi kwa tsiku limodziMaola 24 Galvus50 mgAmatengedwa kawiri patsiku (nthawi zina 1), amagwira ntchito kwa maola 16Maola 24

Ndikofunika kwambiri kudziwa momwe mungapangire kuchuluka kwa shuga m'magazi kuchokera kwa dokotala. Adzawerengera mulingo woyenera, komanso kusankha mankhwalawo othandiza kwambiri pankhani inayake. Osadzisilira.

Mankhwala abwino kwambiri a shuga ndi ati?

Kusankha mankhwala oyenera a matenda a shuga a 2 ndi kofunika kwambiri komanso kofunikira. Pakadali pano, mitundu yopitilira 40 yamankhwala ochepetsa shuga komanso ambiri mwa mayina awo ogulitsidwa amaperekedwa pamsika wamafuta azamalonda.

• Kodi ochiritsa matenda ashuga ndi ati?
• Mankhwala abwino kwambiri amtundu wa shuga
• Mankhwala ati omwe tiyenera kupewa?
• Mankhwala Atsopano a shuga

Koma musakhumudwe. M'malo mwake, kuchuluka kwa mankhwala othandiza komanso apamwamba sikokwanira kwambiri ndipo tidzakambirana pansipa.

Kodi ochiritsa matenda ashuga ndi ati?

Kupatula pa jakisoni wa insulin, mankhwala onse ochizira "matenda okoma" mtundu 2 amapezeka m'mapiritsi, omwe ndiabwino kwambiri kwa odwala. Kuti mumvetsetse zomwe muyenera kusankha, muyenera kumvetsetsa momwe amachitidwe amankhwala amapangira.

Mankhwala onse a matenda a shuga a 2 agawidwa kukhala:

1. Zomwe zimawonjezera chidwi cha maselo kupita ku insulin (masensa).
2. Magenge omwe amalimbikitsa kutulutsa kwa mahomoni kuchokera ku kapamba (chinsinsi). Pakadali pano, madotolo ambiri akuthandiza gulu ili pamapiritsi kwa odwala awo, zomwe sizoyenera kuchita. Amagwiritsa ntchito mphamvu zawo popanga maselo a B kuti azigwira ntchito. Kukomoka kwawo kumayamba msanga, ndipo matenda amtundu wa 2 amadutsa mu 1st. Pali kuperewera kwenikweni kwa insulin.
3. Mankhwala omwe amachepetsa mayamwidwe amthupi kuchokera m'matumbo (alpha glucosidase inhibitors).
4. Mankhwala atsopano.

Mankhwala abwino kwambiri amtundu wa shuga

Pali magulu a mankhwala omwe ndi othandiza, ogwira ntchito komanso otetezeka kwa odwala komanso omwe amakhudza thanzi lawo.

Mankhwala abwino kwambiri a matenda ashuga a 2, omwe nthawi zambiri amaperekedwa kwa odwala, ndi biguanides. Amaphatikizidwa m'gulu la mankhwala, omwe amachititsa kuti matupi onse azigwira ntchito ya mahomoni. Muyezo wagolide ukadali Metformin.

Mayina ake odziwika kwambiri:

• Siofor. Ili ndi mphamvu yofulumira koma yochepa.
• Glucophage. Ili ndi mphamvu pang'onopang'ono komanso yokhalitsa.

Ubwino waukulu wa mankhwalawa ndi awa:

1. Zabwino kwambiri hypoglycemic zotsatira.
2. Kuleza mtima kwabwino.
3. Pafupifupi kupezeka kwathunthu kovuta, kupatulapo kugaya chakudya. Vuto lakuchuluka limakhala nthawi zambiri (kusungunuka m'matumbo).
4. Kuchepetsa chiwopsezo cha kugunda kwamtima ndi mikwingwirima chifukwa cha zomwe zimachitika pakumapezeka kwa lipid.
5. Osatsogolera kukuwonjezeka kwa thupi.
6. Mtengo wololera.

Amapezeka m'mapiritsi a 500 mg. Yoyambira mlingo wa 1 g mu 2 mgulu waukulu kawiri pa tsiku theka la ola musanadye.

Alfa glucosidase inhibitors ndi gulu losangalatsa kwambiri la mankhwala omwe amachepetsa kuyamwa kwa matumbo kuchokera m'matumbo. Woimira wamkulu ndi Acarbose. Zogulitsa ndi Glucobay. Mapiritsi a 50-100 mg ndi zakudya zitatu musanadye. Zimaphatikizidwa bwino ndi Metformin.

Mankhwala ati omwe tiyenera kupewa?

Madokotala nthawi zambiri amati mankhwalawa ndi amtundu wa shuga wachiwiri, omwe amachititsa kuti maselo a B amasulidwe. Njira ngati izi zimapweteketsa wodwala kuposa momwe zimamuthandizira.

Cholinga chake ndikuti kapamba akugwira kale ntchito kawiri mwamphamvu kuposa masiku onse chifukwa chakukaniza kwa minofu kuzichita za mahomoni. Powonjezera ntchito yake, adokotala amangokulitsa njira ya kufooka kwa ziwalo komanso kukulitsa kuchepa kwathunthu kwa insulin.

• Glibenclamide. 1 tabu. kawiri patsiku mutadya,
• Glycidone. 1 piritsi kamodzi patsiku
• Glipemiride. Piritsi limodzi kamodzi tsiku lililonse.

Amaloledwa kugwiritsidwa ntchito ngati chithandizo chamanthawi yochepa kuti muchepetse glycemia. Komabe, muyenera kupewa kugwiritsa ntchito mankhwalawa kwa nthawi yayitali.

Zofanananso ndi meglithinids (Novonorm, Starlix). Amakhetsa mwachangu kapamba ndipo satengera chilichonse chabwino kwa wodwala.

Mankhwala Atsopano a shuga

Nthawi iliyonse, ambiri amayembekeza ndi chiyembekezo, koma kodi pali njira yatsopano yothandizira matenda ashuga? Malangizo a Mtundu Wathu wa Matenda a shuga Ati Amayambitsa Asayansi Kuyang'ana Zipangizo Zatsopano za Chemical.

• Dipeptidyl peptidase-4 (DPP-4) zoletsa:
  • Januvius
  • Galvus
  • Onglisa,
• Glucagon-ngati Peptide-1 Agonists (GLP-1):
  • Baeta
  • Victoza.

Gulu loyamba la mankhwalawa limathandizira kuwonjezera kuchuluka kwa zinthu zomwe zimapangitsa kuti pakhale insulin, koma popanda kufooka kwa maselo a B. Chifukwa chake, zotsatira zabwino za hypoglycemic zimatheka.

Wogulitsa mapiritsi a 25, 50, 100 mg. Mlingo wa tsiku ndi tsiku ndi 100 mg mu 1 mlingo, ngakhale zakudya. Mankhwalawa amagwiritsidwa ntchito kwambiri muzochitika za tsiku ndi tsiku chifukwa chogwiritsa ntchito mosavuta komanso kusowa kwa mavuto.

Agonists a GLP-1 amatha kutulutsa mafuta kagayidwe. Amathandizira wodwalayo kuchepa thupi, mwakutero amalimbikitsa chiwopsezo cha minofu ya thupi ku zotsatira za insulin. Imapezeka ngati cholembera cha jakisoni wa subcutaneous. Mlingo woyambira ndi 0.6 mg. Pambuyo pa sabata la chithandizo chotere, mutha kukweza kwa 1.2 mg moyang'aniridwa ndi dokotala.

Kusankhidwa kwa mankhwala oyenera kuyenera kuchitika mosamala kwambiri ndikuzindikira mawonekedwe onse a wodwala aliyense. Nthawi zina ndikofunikira kuchita insulin yothandizira matenda a shuga a 2. Mulimonsemo, mitundu yambiri ya mankhwala imakhala yodalirika pakuwongolera wodwala aliyense, yemwe sangakhale wosangalala.

Mankhwala Onglisa wochokera ku matenda osokoneza bongo - malangizo tsatanetsatane kuti mugwiritse ntchito

Matendawa masiku ano amakhudza anthu 9% padziko lapansi. Makampani opanga mankhwala ndi machitidwe azachipatala a mayiko otsogola padziko lonse lapansi akuika ndalama mabiliyoni ambiri, ndipo matenda ashuga akuyenda mozungulira dziko lapansi, kuyamba kukhala achichepere, ndikuyamba kukhala ankhanza.

Vutoli likufika pamlingo womwe sunkayembekezeredwa: pofika chaka cha 2020, theka la odwala biliyoni omwe ali ndi matenda a shuga a 2 akunenedweratu, ndipo madokotala sanaphunzire momwe angapewere matendawa moyenera.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Ngati ndi matenda amtundu wa 1 shuga, omwe amakhudza osakwana 10% ya onse odwala matenda ashuga, zonse ndizosavuta: muchepetse kuchuluka kwa glucose m'magazi mwa kubaya insulini (palibe chomwe chingaperekedwe pamenepo) ndipo zonse zikhala bwino (lero, kwa odwala otere, adapanganso kapamba wochita kupanga) ), ndiye ndi matenda a shuga 2, ukadaulo wapamwamba sugwira ntchito.

Mwa fanizo la matenda a shuga a 2, shuga adadziwika kuti ndiye mdani wamkulu, kudzaza msika ndi mankhwala ochepetsa shuga.Mankhwala a odwala matenda ashuga mothandizidwa ndi mapiramidi othandizira amalimbikitsidwa, mankhwala ena akapaka mankhwala amodzi, ndiye kuti mankhwala ena achitatu amawonjezeredwa ku zovuta izi kufikira nthawi ya insulin itafika.

Kwa zaka 20 zapitazi, madokotala akhala akulimbana ndi shuga, koma zotsatira zake zimakhala zotsika, chifukwa zovuta komanso zovuta kuchokera ku mankhwala nthawi zambiri zimapambana, makamaka ngati simumatsatira mlingo, musaganizire kuti mankhwalawo ndiabwino komanso ndani osachita.

Chimodzi mwa ziwalo zomwe tikufuna ndi mtima ndi mtsempha wamagazi. Zimatsimikiziridwa kuti chithandizo chachikulu cha matenda ashuga chimayambitsa zosiyana ndipo zimapangitsa kufa kwa mitsempha. Shuga ndi chizindikiro chabe cha matenda amtundu wa 2; matendawa amatengera metabolic syndrome.

Mankhwala a m'badwo watsopano Onglisa, opangidwa ndi asayansi aku Britain ndi ku Italy, sikuti amangothandiza odwala, komanso luso la mtima. Mankhwala a mndandanda wa maretretin, omwe akuphatikizapo Onglisa, ndi zomwe zapezeka pamunda wa matenda ashuga. Amagwira ntchito kuti achepetse kusadya komanso kuwonda - chimodzi mwazifukwa zazikuluzakhazikitsira matenda a shuga 2.

Kuphatikiza apo, incretinomimetics silipiritsa hypoglycemia, amathandizira kuchepetsa kuthamanga kwa magazi, komanso kuteteza maselo a pancreatic. Mtengo wokwera komanso kusowa kwa chithandizo chachipatala chifukwa chakugwiritsa ntchito mankhwalawa kungachitike chifukwa cha zovuta za Onglisa, koma izi ndizofunikanso nthawi.

Kupanga ndi mawonekedwe a kumasulidwa

Piritsi iliyonse ya Onglisa, chithunzi chake chomwe chaperekedwa m'gawoli, chili ndi 2.5 kapena 5 mg ya saxagliptin hydrochloride mu chipolopolo. Fomuloli idathandizidwa ndi ma excipients: cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate ndi Opadray utoto (woyera, wachikasu ndi wabuluu mapiritsi a 2.5 mg ndi oyera, apinki ndi abuluu pamtundu wa 5 mg).

Mankhwalawa amatha kuzindikiridwa ndi mawonekedwe (mapiritsi a biconvex okhala ndi chikasu chachikasu ndikuwonetsa 2,5 / 4214 ndi pinki wolemba 5/4215). Zolemba zake zimasindikizidwa mbali iliyonse ndi inki wabuluu.

Mutha kugula mankhwala omwe mumalandira. Kwa mapiritsi a Ongliz, mtengo wake suchokera pagulu la bajeti: 30 ma PC. 5 mg ku Moscow muyenera kulipira ma ruble 1700. Wopanga adatsimikiza moyo wamashelefu pazaka zitatu. Malo osungira mankhwalawa ndi muyezo.

Kodi mankhwala a Onglisa adawakonzera chiyani?

Matenda a 2 a mtundu wa 2 amadziwika ndi kuchepa kwamphamvu kwa maselo a pancreatic kupita ku glucose, kuchedwa m'gawo loyamba la insulin synthesis (poyankha zakudya zamatumbo). Ndi kuchuluka kwa matendawa, gawo lachiwiri la kupanga mahomoni limatayika pang'onopang'ono. Amakhulupirira kuti chomwe chimayambitsa kusagwira bwino kwa maselo a beta omwe amapanga insulin ndi kusowa kwa ma insretin. Awa ndi ma peptides omwe amathandizira katulutsidwe ka mahomoni; amapangidwa poyankha kuchuluka kwa shuga m'magazi.

Onglisa akuchedwa kuchitapo kanthu kwa enzyme ya DPP-4, yomwe ndiyofunikira pakuwonongeka kwa ma protein. Zotsatira zake, amakhalabe m'mwazi motalikirapo, zomwe zikutanthauza kuti insulini imapangidwa m'njira yayikulu kuposa masiku onse. Izi zimathandiza kukonza glycemia komanso pamimba yopanda kanthu, ndipo mukatha kudya, mubweretse ntchito ya ziphuphu zakumaso pafupi ndi zathupi. Pambuyo pa kusankha kwa Onglisa, glycated hemoglobin mwa odwala imachepetsedwa ndi 1.7%.

Zochita za Onglises zimatengera kuwonjezeka kwa ntchito yamahomoni ake, mankhwalawa amawonjezera kuchuluka kwawo m'magazi mosachepera 2 times. Glycemia ikangofika yabwinobwino, ma insretin amasiya kukhudzana ndi insulin. Pankhani imeneyi, palibe chowopsa cha hypoglycemia mu odwala matenda ashuga omwe amamwa mankhwalawa. Komanso, mwayi wosakayikitsa wa Onglisa ndikuchepa kwa kuthamanga kwake komanso kuthekera kotenga mapiritsi ena ochepetsa shuga.

Kuphatikiza pa chochita chachikulu, Onglisa amakhalanso ndi zotsatira zina zabwino mthupi:

1. Mankhwalawa amachepetsa kuchuluka kwa glucose kuchokera m'matumbo kulowa m'magazi, motero amathandizira kutsika kwa shuga ndi inshuwaransi ya shuga atatha kudya.
2. Amatenga nawo mbali pamakhalidwe azakudya. Malinga ndi kuwunika kwa odwala, Onglisa amathandizira kumverera kwodzaza, zomwe zimakhala zowona makamaka kwa odwala matenda ashuga onenepa kwambiri.
3. Mosiyana ndi kukonzekera kwa sulfonylurea, komwe kumakulanso kaphatikizidwe ka insulin, Onglisa siivulaza maselo a beta. Kafukufuku awulula kuti samangowononga maselo a pancreatic, koma, mmalo mwake, amateteza komanso kuwonjezera kuchuluka kwawo.

Momwe angatenge

Onglisa adalembera matenda ashuga amtundu 2. Kuchiza kuyenera kuphatikizapo zakudya komanso zolimbitsa thupi. Musaiwale kuti mankhwalawa amachita modekha. Ndi kumwa kosaletseka kwa zakudya zamagalimoto komanso moyo wongokhala, sangathe kubwezera zomwe zimachitika chifukwa cha matenda ashuga.

The bioavailability wa saxagliptin ndi 75%, pazipita kuchuluka kwa zinthu m'magazi zimawonedwa pambuyo pa mphindi 150. Mphamvu ya mankhwalawa imatha pafupifupi maola 24, chifukwa chake sikofunikira kumwa chakudya. Mapiritsi ali mu membala wamakanema, sangathe kuthyoledwa ndi kuphwanyika.

Mlingo watsiku ndi tsiku womwe ndi 5 mg. Kwa odwala okalamba omwe ali ndi vuto lowonda laimpso ndi kwa chiwindi, kusintha kwa mankhwala sikofunikira.

Mlingo wocheperako (2.5 mg) sakonda kutumikiridwa:

ndi kulephera kwa aimpso ndi GFR

Gwiritsani ntchito ndi mankhwala ena

Pofuna kupewa zovuta zambiri za anthu odwala matenda ashuga mamiliyoni ambiri, mankhwala atsopano ndi mitundu yochizira imayambitsidwa nthawi zonse. Chithandizo choyambira pano chimawonedwa ngati kusintha kwa moyo wa metformin +. Ngati izi sizokwanira, yambani kuphatikiza mankhwalawa: onjezerani imodzi mwa mankhwala ovomerezeka ku chithandizo chomwe chilipo.

Tsoka ilo, si onse omwe ali otetezeka komanso ogwira ntchito mokwanira:

Onglisa pankhani yothandizika ndiofanana ndi mankhwala omwe ali pamwambapa, ndipo pankhani yachitetezo ndi kuchepetsedwa kwa contraindication, imawonjezera kwambiri, chifukwa chake akuganiza kuti iwonjezedwa kwa odwala.

Russian Endocrinologists Association ivomereza kugwiritsa ntchito ma DPP-4 zoletsa kuphatikiza ndi metformin ngati mzere woyamba wa chithandizo cha matenda ashuga. Mankhwalawa onse samathandizira hypoglycemia, zimakhudza chifukwa chachikulu cha shuga kuchokera ku ngodya zosiyanasiyana: zimakhudza kukana kwa insulini komanso kusokonekera kwa cell ya beta.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Zotsatira Zakafukufuku: Onglisa amachepetsa GH pafupifupi 1.7%, metformin - ndi 2%, kuphatikiza kwawo - mwa 2,5%.

Kuti achepetse dongosolo la chithandizo, wopanga yemweyo adapanga Combogliz Prolong. Mapiritsiwo ali ndi 500 kapena 1000 mg ya metformin yowonjezera-kutulutsa ndi 2.5 kapena 5 mg ya saxagliptin. Mtengo wa phukusi la pamwezi ndi pafupifupi ma ruble 3300. Analogue yathunthu ya mankhwalawa ndi kuphatikiza kwa Ongliza ndi Glucofage Long, zimatengera rubles chikwi zotsika mtengo.

Ngati onse mankhwalawa pazomwe mulingo woyenera sapereka pakufunikira kwa matenda a shuga, amaloledwa kuwonjezera sulfonylureas, glitazones, insulini ku regimen yothandizira.

Kodi ndizotheka kusintha china

Onglisa ndiye mankhwala a saxagliptin okha mpaka pano. Ndili m'mawa kwambiri kunena za mawonekedwe a mitengo yotsika mtengo, chifukwa chitetezo cha patent chimaletsa kukopera choyambirira cha mankhwala atsopano. Chifukwa chake, wopanga amapatsidwa mwayi wokonzanso kafukufuku wokwera mtengo, kuti alimbikitse kupitiliza kwina kwa mankhwala opangira mankhwala. Yembekezerani zotsika mtengo Ongliza sikuyenera.

M'masitolo ogulitsa aku Russia, kuphatikiza pa Onglisa, mutha kugula mapiritsi kuchokera pagulu lomwelo la Galvus ndi Januvius. Mankhwalawa amathandizira kwambiri matenda a shuga; kufananizira pankhani yachitetezo ndi kuchita bwino sikunawonetse kusiyana kwakukulu pakati pawo. Malinga ndi ndemanga za anthu odwala matenda ashuga, mutha kuwapeza kwaulere osati kumadera onse, ngakhale kuti onse pachaka amaphatikizidwa pagulu la mankhwala ofunikira.

Kugula pawokha mankhwalawa kumawononga ndalama zambiri:

Mutha kuyitanitsa mapiritsi otsika mtengo mumafakitare apakompyuta. Mwa chachikulu kwambiri mwaiwo mungathe kumasuka ndi mankhwalawo kuchokera kuzipatala zomwe zili pafupi ndi nyumba.

Mu 2017, kumasulidwa kwa mankhwala ophatikiza ndi saxagliptin ndi dapagliflozin otchedwa Qtern adalengezedwa. Zimaphatikiza zabwino za imodzi mwazamankhwala apamwamba kwambiri a shuga - Forsigi ndi Onglisa. Ku Russia, mapiritsi atsopano sanalembetsedwebe.

Ndemanga Zahudwala

Zotsatira zake, sabata limodzi lokha shuga wanga wovomerezeka adakhala wabwino. Mwayi wofunikira wa Ongliza ndimaona kuthekera kwake kuthetsa mkwiyo. Tsoka ilo, inenso sindingathe kulakalaka chakudya changa. Ndizosavuta kuti onse Onglizu ndi Glucofage Long atengedwe kamodzi patsiku. Ndinkamwa usiku - tsiku lotsatira simungathe kuganiza za chithandizo.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Zotsatira za pharmacological

Chofunikira chachikulu cha Onglisa ndi saxagliptin. Pasanathe tsiku limodzi atalowa m'mimba, zimalepheretsa ntchito ya DPP-4 peptide. Mukakumana ndi glucose, kuponderezedwa kwa enzyme modabwitsa (katatu) kumathandizira kubisalira kwa glucagon-ngati peptide-1 (GLP-1) ndi glucose-wodalira insulinotropic polypeptide (HIP).

Nthawi yomweyo, kuchuluka kwa glucagon mu b-cell kumachepa, ntchito ya ma b-cell omwe amachititsa kuti ma cell a insulin achuluke. Zotsatira zake, zizindikiro za kusala ndi postprandial glycemia zimachepetsedwa kwambiri.

Chitetezo ndikuyenda bwino kwa mankhwalawa adaphunziridwa poyesa 6, momwe amodzi odzipereka a 4148 omwe adatenga nawo matenda amtundu wa 2 adatenga nawo gawo. Onse ogwira nawo ntchito adawonetsa kusintha kwa glycated hemoglobin, shuga yokhala ndi njala ndi glycemia pambuyo ponyamula katundu. Mankhwala owonjezera, monga thiazolidinediones, metformin, glibenclamide, adawerengedwa kwa omwe atenga nawo gawo omwe sanakwaniritse 100% glycemic control.

Odwala omwe ali ndi mankhwala owonjezera a antiidiabetes amawonetsa zotsatira zofananazo. Kulemera kwa onse omwe atenga nawo mayesowa kunakhazikika.

Pharmacokinetics ndi pharmacodynamics

Mu thupi, saxagliptin imamwilidwa msanga mukatha kudya musanadye. Pambuyo pakukonzekera pakamwa, pafupifupi 75% ya mlingo imamwa. Ndi agologolo magazi saxagliptin ndi ake metabolite mangani pang'ono.

Kuchuluka kwa saxagliptin ndi metabolite yake yayikulu kumawonedwa ndi plasma kwa maola 2 ndi maola 4, motero.

Pafupifupi, kutalika kwa gawo lotsiriza la theka la moyo ndi metabolite ndi maola a 2,5 ndi maola 3.1, motero. Amayamwa mu ndulu ndi mkodzo.

Zotsatira zoyipa

Zotsatira zoyipa zotsatirazi zimachitika pakukonzekera kwa mankhwalawa Onglisa:

• matenda a kwamkodzo thirakiti ndi matenda apamwamba thirakiti
• sinusitis,
• gastroenteritis
• kusanza
• mutu.

Pa maziko a mankhwala ophatikizika ndi metformin angachitike nasopharyngitis, mutu.

Onglisa, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Iyenera kutengedwa pakamwa, ngakhale nthawi yayitali ya chakudya.

Ngati wodwalayo adapangidwa kuti akhale ndi monotherapy, amalimbikitsidwa kumwa mapiritsi a 5 mg a saxagliptin kamodzi patsiku.

Ngati mankhwala ophatikizidwa amupangira, ndikofunikira kutenga 5 mg ya saxagliptin kamodzi patsiku, kuphatikiza ndi thiazolidinediones ndi Metformin, ndimankhwala omwe amachokera ku sulfonylurea.

Kumayambiriro kwa chithandizo chophatikizidwa ndi Metformin, mlingo wa saxagliptin ndi 5 mg, ndipo mlingo wa Metformin ndi 500 mg patsiku.

Wodwala akaphonya kumwa Onglisa, ndikofunikira kumwa mapiritsi atangomaliza kukumbukira izi. Osamamwa kawiri mlingo.

Odwala ofatsa kulephera kwa aimpso sangasinthe mlingo. Odwala omwe ali ndi vuto lalikulu laimpso kapena olimbitsa, komanso omwe alipo hemodialysis, muyenera kumwa mankhwala a 2.5 mg patsiku. Muyenera kumwa mapiritsi atatha hemodialysis.

Ngati wodwalayo nthawi yomweyo amagwiritsa ntchito ma CYP 3A4 / 5 zoletsa, mlingo wa Onglisa uyenera kukhala 2.5 mg patsiku.

Malangizo apadera

Tiyenera kukumbukira kuti kugwiritsa ntchito mankhwalawa Onglisa limodzi ndi insulin komanso monga mbali yamankhwala atatu (Metformin, thiazolidinediones, sulfonylurea zotengera) sanaphunzirepo pakadali pano.

Palibe maphunziro omwe adachitika pokhudzana ndi momwe mankhwalawo amathandizira poyendetsa magalimoto ndikugwirira ntchito molondola. Komabe, ziyenera kudziwidwa kuti mutatha kumwa mankhwalawa zimatha kuchitika chizungulire.

Ma Analogs a Onglises

Palibe kufanana kwa Onglises pazomwe zimagwira. Zofanana mthupi zimagwira ntchito Nesina, Januvia, Galvus, Trazenta, Comboglize XR. Ndi zoletsedwa kumwa mankhwalawa popanda mankhwala a dokotala.

Zosagwiritsidwa ntchito kwa odwala osakwana zaka 18.

Mlingo Wovomerezeka ndi Kachitidwe

Ndi kupitilira kwa matenda a shuga a 2, endocrinologist ayenera kusankha mankhwalawa. Amakulolani kuti muchepetse kuchuluka kwa shuga m'magazi.

Chimodzi mwa zida izi ndi Onglisa. Musanagule, ndikofunika kuti odwala adziwe zofunikira za mankhwalawa. Malangizo ogwiritsira ntchito Onglises, analogues, ndemanga ndi mtengo - odwala matenda ashuga ayenera kukhala ndi chidwi ndi chilichonse.

The endocrinologist ayenera kupereka mankhwala, kutengera momwe wodwalayo alili.

Ndi "Onglise" monotherapy, chisankhocho nthawi zambiri chimapangidwa mokomera mapiritsi a 5 mg. Amatengedwa kamodzi patsiku.

Pogwiritsa ntchito njira zophatikizira zamankhwala, tikulimbikitsidwa kumwa saxagliptin mu 5 mg molumikizana ndi zotumphukira za sulfonylurea, mankhwala a thiazolidinedione, metformin.

Popeza ndaganiza zoyamba kuphatikiza mankhwalawa ndi metformin ndi saxagliptin, ndikofunikira kusankha mankhwalawo kuti chinthu choyamba chimalowa mthupi mu 500 mg, chachiwiri - 5 mg patsiku. Palibe yankho lokwanira, onjezani mlingo wa metformin.

Ngati piritsi lotsatira la Ongliza lasowa, ndiye kuti muyenera kumwa nthawi yomweyo wodwala matenda ashuwalawo akamakumbukira. Koma simungathe kumwa mapiritsi 2 patsiku.

Mlingo wa odwala omwe matenda ashuga amakumana ndi matenda amtunduwu amasankhidwa mosiyana:

• Ndi kulephera kwamphuno, mankhwalawa sasinthidwa,
• Kulephera kwapakati komanso mwamphamvu kwa impso, "Ongliza" imalembedwa 2,5 mg (mapiritsi omwewo akulimbikitsidwa kwa odwala omwe ali ndi hemodialysis),
• kukanika kwa chiwindi sikufuna kusintha kwa mlingo,
• Okalamba odwala ndi yachibadwa impso ntchito, mankhwala zotchulidwa muyezo Mlingo.

Musanamwe mankhwala omwe amapangidwa pamaziko a saxagliptin, muyenera kuyang'ana impso, kuwunika ntchito yawo.

Koma malangizo ogwiritsira ntchito akunena kuti ndi mankhwala osokoneza bongo, mankhwalawa ayenera kuperekedwa ndi hemodialysis. Kwa maola 4, 23% ya mankhwalawa amachotsedwa.

Popereka mankhwala a Onglisa, madokotala safuna kudziwa mtundu wa mankhwala omwe mumagwiritsabe ntchito. Kupatula apo, chiwopsezo cha kuyanjana kwakukulu kwa mankhwalawa ndimankhwala ena ndizochepa kwambiri.

Kuphatikizika kwa metabolite yayikulu ya saxagliptin kumatha kuchepa pogwiritsa ntchito CYP 3A4 / 5 isoenzymes (monga Phenobarbital, Carbamazepine, Phenytoin, Dexamethasone, Rifampicin).

Mukaphatikizidwa ndi mankhwala a sulfonylurea, muyenera kusamala: hypoglycemia ikhoza kuyamba. Mutha kuchepetsa chiwopsezo pochepetsa kukonzekera kwa sulfonylurea.

Asanapeze mankhwala okwera mtengo ngati amenewa, ambiri amafuna kudziwa kuti ndi othandiza bwanji komanso ngati amathandiza odwala ena. Koma chidwi cha anthu odwala matenda ashuga kupita ku mankhwala a saxagliptin sichimodzimodzi: kwa odwala ena mankhwalawa amakhala panacea, pomwe ena amadandaula chifukwa chosakwanira.

Koma kuwunika kwa odwala kumapereka mpata wothana ndi machitidwe a mankhwalawa. Ngakhale malingaliro a anthu ena, odwala matenda ashuga ayenera kuwongoleredwa ndi malingaliro awo omwe amathandizira endocrinologist. Ngati samukhulupirira, ndiye kuti ndiyenera kuyesa kusintha adokotala.

Odwala ena amadandaula kuti Onglisa samatulutsa zotsatira zomwe amayembekeza. Mwa ena, kuchuluka kwa shuga kumachulukanso ngakhale mukumwa mankhwalawo. Madokotala amapereka "Ongliz" ambiri ngati njira yowonjezeramo mankhwala a "Siofor", "Diabeteson".

Koma odwala matenda ashuga ambiri, ngakhale ndi monotherapy yokhala ndi saxagliptin, amatha kukwanitsa bwino komanso kuwongolera glycemia. Phindu la mankhwalawa, ambiri amati amatha kumwa mapiritsi nthawi iliyonse, mosasamala kanthu za kudya.

Ena amanenanso kuti kuphatikiza ndi metformin kumathandizira kuti zizikhala bwino. Koma kuti mukwaniritse zotsatira zomwe mukufuna, chithandizo cha nthawi yayitali chimafunikira. Ndipo izi ndizosangalatsa kwa ambiri.

Ngati dokotala akuwonetsa "Ongliza", ndiye muyenera kuyesa mankhwala ndi mankhwalawa. Chinthu chachikulu chomwe muyenera kukumbukira ndikufunika kotsatira zakudya komanso kugwiritsa ntchito mphamvu zolimbitsa thupi. Ngati mupuma ndikumwa mapiritsi okhawo, ndiye kuti simungathe kusintha momwe ziliri.

Iyenera kutengedwa pakamwa, ngakhale nthawi yayitali ya chakudya.

Ngati wodwalayo adapangidwa kuti akhale ndi monotherapy, amalimbikitsidwa kumwa mapiritsi a 5 mg a saxagliptin kamodzi patsiku.

Ngati mankhwala ophatikizidwa amupangira, ndikofunikira kutenga 5 mg ya saxagliptin kamodzi patsiku, kuphatikiza ndi thiazolidinediones ndi Metformin, ndimankhwala omwe amachokera ku sulfonylurea.

Kumayambiriro kwa chithandizo chophatikizidwa ndi Metformin, muyeso wa saxagliptin ndi 5 mg, ndi mlingo wa Metforminamg patsiku.

Wodwala akaphonya kumwa Onglisa, ndikofunikira kumwa mapiritsi atangomaliza kukumbukira izi. Osamamwa kawiri mlingo.

Odwala ofooka aimpso amalephera kusintha muyezo. Odwala omwe ali ndi vuto lalikulu laimpso kapena olimbitsa, komanso omwe ali ndi hemodialysis, ayenera kumwa mankhwalawa 2.5 mg tsiku lililonse. Muyenera kumwa mapiritsi atatha hemodialysis.

Ngati wodwalayo nthawi yomweyo amagwiritsa ntchito ma CYP 3A4 / 5 zoletsa, mlingo wa Onglisa uyenera kukhala 2.5 mg patsiku.

Palibe kufotokozeredwa kwa zizindikiro za kuledzera ndi ntchito yayitali yayitali. Pankhani ya bongo wambiri, chithandizo chamankhwala chimachitika. Zomwe zimagwira ndi metabolite yake zimatha kuchotsedwa m'thupi ndi hemodialysis.

Malinga ndi kafukufuku wofufuza, pali chiopsezo chochepa chokhudzana kwambiri ndi saxagliptin ndi mankhwala ena.

Pogwiritsa ntchito munthawi yomweyo ndi CYP 3A4 / 5 isoenzyme inducers (Dexamethasone, Carbamazepine, Phenobarbital, Rifampicin, Phenytoin), kugwiritsidwa ntchito kwa metabolite yayikulu ya saxagliptin kungachepe.

Popeza zochokera ku sulfonylurea zimatha kupangitsa chiwonetsero cha hypoglycemia kuti muchepetse ngozi, zingakhale zofunikira kuti muchepetse mlingo wa zotumphukira za sulfonylurea mukamamwa ndi Onglisa.

Ndemanga zawo zimakonda kunena kuti Onglisa amalola odwala matenda ashuga kuti azigwiritsa ntchito mokwanira shuga. Amadziwika kuti mankhwalawa ndi osavuta kugwiritsa ntchito, zovuta zomwe zimachitika panthawi ya chithandizo ndizosowa. Mfundo yosatsatsa kwa ogwiritsa ntchito ndi mtengo wokwera wa mankhwalawo.

Matendawa masiku ano amakhudza anthu 9% padziko lapansi. Makampani opanga mankhwala ndi machitidwe azachipatala a mayiko otsogola padziko lonse lapansi akuika ndalama mabiliyoni ambiri, ndipo matenda ashuga akuyenda mozungulira dziko lapansi, kuyamba kukhala achichepere, ndikuyamba kukhala ankhanza.

Vutoli likufika pamlingo womwe sunkayembekezeredwa: pofika chaka cha 2020, theka la odwala biliyoni omwe ali ndi matenda a shuga a 2 akunenedweratu, ndipo madokotala sanaphunzire momwe angapewere matendawa moyenera.

Ngati ndi matenda amtundu wa 1 shuga, omwe amakhudza osakwana 10% ya onse odwala matenda ashuga, zonse ndizosavuta: muchepetse kuchuluka kwa glucose m'magazi mwa kubaya insulini (palibe chomwe chingaperekedwe pamenepo) ndipo zonse zikhala bwino (lero, kwa odwala otere, adapanganso kapamba wochita kupanga) ), ndiye ndi matenda a shuga 2, ukadaulo wapamwamba sugwira ntchito.

Mwa fanizo la matenda a shuga a 2, shuga adadziwika kuti ndiye mdani wamkulu, kudzaza msika ndi mankhwala ochepetsa shuga. Mankhwala a odwala matenda ashuga mothandizidwa ndi mapiramidi othandizira amalimbikitsidwa, mankhwala ena akapaka mankhwala amodzi, ndiye kuti mankhwala ena achitatu amawonjezeredwa ku zovuta izi kufikira nthawi ya insulin itafika.

Kwa zaka 20 zapitazi, madokotala akhala akulimbana ndi shuga, koma zotsatira zake zimakhala zotsika, chifukwa zovuta komanso zovuta kuchokera ku mankhwala nthawi zambiri zimapambana, makamaka ngati simumatsatira mlingo, musaganizire kuti mankhwalawo ndiabwino komanso ndani osachita.

Chimodzi mwa ziwalo zomwe tikufuna ndi mtima ndi mtsempha wamagazi. Zimatsimikiziridwa kuti chithandizo chachikulu cha matenda ashuga chimayambitsa zosiyana ndipo zimapangitsa kufa kwa mitsempha. Shuga ndi chizindikiro chabe cha matenda amtundu wa 2; matendawa amatengera metabolic syndrome.

Mankhwala a m'badwo watsopano Onglisa, opangidwa ndi asayansi aku Britain ndi ku Italy, sikuti amangothandiza odwala, komanso luso la mtima. Mankhwala a mndandanda wa maretretin, omwe akuphatikizapo Onglisa, ndi zomwe zapezeka pamunda wa matenda ashuga.

Kuphatikiza apo, incretinomimetics silipiritsa hypoglycemia, amathandizira kuchepetsa kuthamanga kwa magazi, komanso kuteteza maselo a pancreatic. Mtengo wokwera komanso kusowa kwa chithandizo chachipatala chifukwa chakugwiritsa ntchito mankhwalawa kungachitike chifukwa cha zovuta za Onglisa, koma izi ndizofunikanso nthawi.

Mankhwala a gulu lamagulu ampretin am'badwo waposachedwa kwambiri. Ndi malingaliro onse adotolo, Ongliz amaloledwa nthawi zambiri ndi ambiri odwala matenda ashuga.

• Matenda a Dyspeptic
• Mutu
• Pancreatitis
• Matenda opatsirana
• Matenda a urogenital a matenda opatsirana.

Ngati chimodzi mwazizindikirozi kapena kusokonezeka kwina kwina kukuchitika, muyenera kuyimitsa kugwiritsa ntchito mankhwalawa ndikuwonana ndi dokotala.

Pazifukwa zasayansi, mankhwalawo adaperekedwa kwa odzipereka mu Mlingo wopitilira muyeso ka 80. Zizindikiro za kuledzera sizokhazikika. Saxagliptin yowonjezera imatha kuchotsedwa pogwiritsa ntchito hemodialysis.

Malinga ndi kuchuluka kwa kafukufuku wasayansi, zotsatira za kulumikizana kwa Onglisa ndi zinthu zina panthawi yovuta ya mankhwalawa sizofunikira.

Zotsatira zakuthandizidwe kwa mankhwalawa pakumwa mowa, ndudu, zakudya zingapo, mankhwala othandizira kunyumba sanakhazikitsidwe.

Mu mawonekedwe apiritsi, kuchokera pamndandanda wa ma incretin, pamodzi ndi Onglisa, Galvus ndi Januvia amamasulidwa, cholembera - Baetu ndi Viktoza.

Saxagliptin akapatsidwa

Anthu odwala matenda ashuga a mtundu 2

1. Monga monotherapy, kuphatikiza kusintha kwamachitidwe,
2. Kuphatikiza, ndikuphatikiza kwa njira yapita ndi metformin, ngati monotherapy sichimapereka chiwongolero chonse cha glycemia,
3. Pamodzi ndi zotumphukira za sulfanylurea ndi thiazolidatediones, ngati kuphatikiza kwatha sikunali kokwanira. Ndi ndani yemwe wapangidwira ku Ongliza

Popeza saxagliptin ndi chothandizira champhamvu chomwe chimapangitsa ntchito ya maselo a B ndikulephera kugwira ntchito kwa maselo a b, chitha kugwiritsidwa ntchito ndi malire, makamaka, mankhwalawa sanasonyezedwe:

• Amayi oyembekezera komanso oyembekezera
• Muubwana,
• Anthu odwala matenda ashuga a mtundu woyamba,
• Ndi mtundu wa 2 wodwala insulin,
• Matenda a shuga ketoacidosis
• Ngati wodwala salola galactose,
• Ndi hypersensitivity pazomwe zimapangidwira.

Mukamasankha mtundu wa mankhwala, dokotala samangoyang'ana pa zomwe zaphatikizidwa, komanso mawonekedwe a saxagliptin a mankhwalawa omwe wodwala matenda ashuga amatenga ku matenda oyanjana. Chifukwa chake, mankhwala onse omwe munthu wodwala matenda ashuga amawagwiritsa ntchito limodzi, dokotala amayenera kudziwitsidwa munthawi yake.

Malangizo ogwiritsira ntchito

Dokotalayo ndi amene amawerengera kuchuluka kwa mankhwalawo payekhapayekha, poganizira zotsatira za mayeso, zaka, magawo a matendawo, momwe thupi limayendera. Kwa Onglisa, malangizo ogwiritsira ntchito amalimbikitsa kumwa mapiritsiwo pakamwa, osamangidwa nthawi yakudya. Muyeso woyamba wa mankhwalawa ndi 5 mg / tsiku.

Kumayambiriro kwa mapangidwe a mankhwalawa, mawonekedwe apamwamba amawoneka motere:

1. Saksagliptin - 5 mg / tsiku.,
2. Metformin - 500 mg / tsiku.

Pambuyo masiku 10-15, onetsetsani momwe mankhwalawo adasinthira ndipo ngati kuli kotheka, sinthani mlingo wa metformin, sungani mulingo wa Onglisa osasinthika.

Ngati nthawi yakumwa mankhwalawo ikusowa, imamwa mankhwalawo nthawi yoyamba. Simungathe kuchita zofananira, chifukwa thupi limafunikira nthawi kuti lizisinthe.

Ngati pali mbiri yodwala matenda a impso, ndiye kuti palibe chifukwa chodalira. Ndi mawonekedwe olimbitsa komanso okhwima, chizolowezi chimachepetsedwa nthawi 2 - 2,5 mg / tsiku. (nthawi imodzi).

Pa hemodialysis, piritsi imatha kumwa pamapeto a njirayi. Zotsatira za Onglisa kwa odwala omwe ali ndi ziwalo zam'mimba za m'mimba sizinaphunzire. Musanapereke mankhwala komanso nthawi yonseyi, ndikofunikira kuwunika momwe impso zimayendera.

Ndi hepatic pathologies, mankhwalawa amatchulidwa muyezo mlingo wa 5 mg / tsiku. Kwa odwala matenda ashuga okalamba, kumwa mankhwala sikofunikira, koma vuto la impso liyenera kuganiziridwanso.

Mlingo wa ma insretins umachepetsedwa ndi theka ndi zovuta mankhwala okhala ndi zoletsa:

• Atazanavir
• Ketoconazole,
• Igraconazole
• Nelfinavir
• Clarithromycin
• Ritonavir
• Saquinavir,
• Indinavir
• Telithromycin.

Palibe chidziwitso chakuvomerezeka pakugwiritsa ntchito mankhwalawa kwa amayi apakati ndi ana osakwana zaka 18, chifukwa chake, ma fanizo amasankhidwa m'gulu la odwala matenda ashuga.

Zosafunika zotsatira ndi mankhwala osokoneza bongo

Mankhwala a gulu lamagulu ampretin am'badwo waposachedwa kwambiri. Ndi malingaliro onse adotolo, Ongliz amaloledwa nthawi zambiri ndi ambiri odwala matenda ashuga.

Nthawi zina, zotsatirazi zalembedwa:

• Matenda a Dyspeptic
• Mutu
• Pancreatitis
• Matenda opatsirana
• Matenda a urogenital a matenda opatsirana.

Ngati chimodzi mwazizindikirozi kapena kusokonezeka kwina kwina kukuchitika, muyenera kuyimitsa kugwiritsa ntchito mankhwalawa ndikuwonana ndi dokotala.

Pazifukwa zasayansi, mankhwalawo adaperekedwa kwa odzipereka mu Mlingo wopitilira muyeso ka 80. Zizindikiro za kuledzera sizokhazikika. Saxagliptin yowonjezera imatha kuchotsedwa pogwiritsa ntchito hemodialysis.

Malangizo owonjezera

Saxagliptin sanalembedwe mndandanda wapatatu momwe ma jakisoni a insulin amaphatikizidwira ndi metformin ndi thiazolidinediones, popeza zotsatira za kuyanjanazi sizinaphunzire. Kuwongolera impso kumachitika pa magawo onse a chithandizo ndi Onglisa, koma ndi mawonekedwe ofatsa, mlingo wake sasinthidwa, nthawi zina amachepetsa.

Saxagliptin pokhudzana ndi zotsatira za hypoglycemic ndiotetezeka konsekonse, koma kuphatikiza ndi mankhwala a sulfonylurea kumatha kupangitsa zochitika za hypoglycemic. Chifukwa chake, ndi zovuta chithandizo, titration wa chomaliza m'njira yochepetsera ndizovomerezeka.

Pankhani ya tsankho la mankhwalawa opatsirana - DPP-4 zoletsa, Onglisa sakusungidwanso, popeza nthawi zina thupi limasokonekera kuyambira pakhungu loyipa mpaka kugunda kwa anaphylactic ndi angioedema, likufuna kuchotsedwa kwa mankhwala mwachangu.

Popeza mankhwalawa ali ndi lactose, sikuti amaperekedwa kwa odwala matenda ashuga omwe amalephera kutulutsa, kuperewera kwa lactose, shuga-galactose malabsorption.

Panthawi yowunika odwala matenda ashuga atatha kulandira chithandizo ndi Onglisa, panali zochitika zina za chitukuko cha kapamba. Popereka mankhwala a saxagliptin, wodwalayo ayenera kudziwitsidwa za chizindikiro: kupweteka kosalekeza komanso koopsa kwa epigastrium.

Ngati m'mimba mulibe vuto, muyenera kusiya kumwa mankhwalawo ndikuwuza adotolo. Zotsatira zake zimakhala zosakhalitsa komanso zosinthika, zimangopita kwa iwo atasiya kumwa mankhwalawo.

Mu aimpso kukanika modekha ndi wowonda mawonekedwe, limodzi mlingo kusanza. M'mavuto akulu, Onglizu amagwiritsidwa ntchito mosamala, panthawi yodwala, pomwe wodwala sangathe popanda hemodialysis, osagwiritsa ntchito konse. Kuwunika momwe impso zimachitikira nthawi yomweyo isanayambike maphunziro ndipo miyezi isanu ndi umodzi yonse yogwiritsidwa ntchito ndi Ogliza.

Zochitika pochiza odwala matenda ashuga okalamba (kuyambira zaka 75) sizokwanira, chifukwa chake, gulu ili la odwala limafunikira chidwi chachikulu.

Zotsatira za kuthekera kwa Onglisa pakuwongolera mayendedwe kapena njira zovuta sizinafalitsidwe, chifukwa chake, odwala matenda ashuga ayenera kumwa mankhwalawa mosamala, makamaka chifukwa chizungulire chimachitika pakati pamavuto. Kuchita chidwi kwambiri ndi zoterezi zimafunika kwa odwala omwe amagwiritsa ntchito Onglisa mu chithandizo chovuta, chifukwa mankhwala ena othandizira amatha kudzetsa hypoglycemia.

Kugwiritsa ntchito mankhwalawa pamatenda amtima kumaonetsa kuti mankhwalawa amateteza kugunda kwa mtima. Ku America, ngakhale ndi kuchuluka kwa shuga kwa nthawi yayitali, adotolo amafotokozera odwala matenda ashuga omwe ali ndi arrhythmia Onglizu kuti athandizire kukomoka kwa glycemic komanso kubwezeretsa kugunda kwa mtima.

Kuyanjana ndi Mankhwala ndi Onglisa ndi fanizo

Malinga ndi kuchuluka kwa kafukufuku wasayansi, zotsatira za kulumikizana kwa Onglisa ndi zinthu zina panthawi yovuta mankhwala sizinafotokozeredwe ngati zofunika kwambiri pakubwera.

Zotsatira zakuthandizidwe kwa mankhwalawa pakumwa mowa, ndudu, zakudya zingapo, mankhwala othandizira kunyumba sanakhazikitsidwe.

Mu mawonekedwe apiritsi, kuchokera pamndandanda wa ma incretin, pamodzi ndi Onglisa, Galvus ndi Januvia amamasulidwa, cholembera - Baetu ndi Viktoza.

Makina a akatswiri ndi ogwiritsa ntchito

Pamabwalo azokambirana za mankhwala Ongliza, ndemanga zake ndizabwino, mwina kungobweza mtengo ndi mtengo womwe ukufanana ndi mtundu wake wa ku Europe.

Tsoka ilo, matenda, monga ukalamba, sangasinthe ndipo sangapeweretu, chifukwa thanzi, monga mukudziwa, silingagulidwe, ndipo mtundu wa matenda ashuga a 2 samatchedwa mwangozi tikiti ya njira imodzi.

Koma kapamba amene ali ndi matenda ashuga omwe ali ndi mtundu wachiwiri sakhazikika, amakhala ndi malo obwezeretsanso ntchito zake, ndikuwathetsa ngati osagwira (kuchokera pamalingaliro a insulin secretion).

Asanamasule Ongliza kumsika, wopanga adagwiritsa ntchito mabiliyoni ambiri osati kungowonetsa kusakhala ndi zotsatirapo zoipa, komanso kutsimikizira momwe amagwirira ntchito. Ngati mankhwalawa angathandizire kuchedwetsa zovuta kwa zaka 10- 20, ngakhale nthawi yino yodzaza (popanda vuto la mtima, chibadwa, ziwopsezo, khungu, kusabala, kuperewera kwa impso), ndikofunika kuyang'anitsitsa.

Ndemanga za kuthekera kwa Onglisa ndi zotsatira za mankhwala a shuga pa thanzi la endocrinologist Shmul Levit, mutu. Institute of Diabetesology, onani vidiyo:

Mukamagwiritsa ntchito ongliza

Mankhwala amathandizidwa ndi odwala omwe ali ndi matenda amtundu wa 2 matenda ngati awa:

• Ndi monotherapy ndi mankhwalawa limodzi ndi zolimbitsa thupi komanso zakudya,
• Ndi mankhwala othandizira osakanikirana ndi metformin,
• Palibe mphamvu ya monotherapy ndi metformin, mankhwala a sulfonylurea, thiazolidinediones ngati mankhwala ena.

Ngakhale kuti mankhwala osokoneza bongo akhala akupanga kafukufuku ndi mayeso angapo, kuwunika za izi ndizabwino kwambiri, chithandizo chokhacho chitha kuyamba kuyang'aniridwa ndi dokotala.

Mankhwala

Saxagliptin ndi njira yosinthira masinthidwe obwezeretsanso a dipeptidyl peptidase-4 (DPP-4). Mtundu wachiwiri wa matenda ashuga, makulidwe ake amatsogolera ku kuponderezedwa kwa ntchito ya DPP-4 kwa maola 24.

Pambuyo pakulowetsa shuga, kuletsa kwa DPP-4 kumapangitsa kuti chiwonetsero cha glucose-insulinotropic polypeptide (HIP) cha glucose komanso glucagon chizindikirike, zomwe zimayambitsa kuchuluka kwa glucagon C-peptide ndi insulin.

Kuchepetsa kumasulidwa kwa glucagon ku ma cell a pancreatic alpha ndikutulutsa kwa insulin ndi maselo a pancreatic beta kumabweretsa kuchepa kwa kusala kwa postprandial glycemia ndi glycemia.

Chifukwa cha kafukufuku wotsogozedwa ndi placebo, zidapezeka kuti kutenga Ongliza kumapitilira posintha kwambiri kuchuluka kwa glucose (GPN), glycosylated hemoglobin (HbA1c) ndi postprandial glucose (PPG) m'magazi am'magazi poyerekeza ndi kuwongolera.

Odwala omwe sanathe kukwaniritsa gawo la glycemic pamene akutenga saxagliptin monga monotherapy amadziwikanso ngati metformin, thiazolidinediones kapena glibenclamide. Mukamatenga 5 mg ya saxagliptin, kuchepa kwa HbA1c kumawonedwa pambuyo pa masabata 4, GPN - atatha masabata awiri.

Poyerekeza ndi kumbuyo kwa kutenga Onglisa, kuwonjezeka kwa thupi sikudziwika. Zotsatira za saxagliptin pa lipid mbiri ndizofanana ndi za placebo.

Pharmacology ndi pharmacokinetics

Mu thupi, saxagliptin imamwilidwa msanga mukatha kudya musanadye. Pambuyo pakukonzekera pakamwa, pafupifupi 75% ya mlingo imamwa. Saxagliptin ndi metabolite yake imamangiriza pang'ono pamapuloteni amwazi.

Kuchuluka kwa saxagliptin ndi metabolite yake yayikulu kumawonedwa ndi plasma kwa maola 2 ndi maola 4, motero.

Pafupifupi, kutalika kwa gawo lotsiriza la theka la moyo ndi metabolite ndi maola a 2,5 ndi maola 3.1, motero. Amayamwa mu ndulu ndi mkodzo.

Zotsatira za mankhwalawa pa odwala matenda ashuga zimachitika chifukwa cha zomwe zimachitika. Ikalowa mthupi, saxagliptin imalepheretsa enzyme DPP-4. Zotsatira zake, maselo a pancreatic beta amathandizira kaphatikizidwe ka insulin. Kuchuluka kwa glucagon panthawiyi kumachepa.

Chifukwa cha izi, kuchuluka kwa shuga m'magazi a wodwalayo kumachepetsedwa, zomwe zimapangitsa kuti zinthu zikhale bwino (pokhapokha mlingo wake umatsika mpaka pamavuto). Chofunikira kwambiri pazinthu zomwe zikufunsidwa ndizoperewera pa thupi la wodwalayo. Odwala omwe amagwiritsa ntchito Ongliza samonda.

Kuchepetsa kwa saxagliptin kumachitika mwachangu ngati mumwa mankhwalawa musanadye. Nthawi yomweyo, gawo lalikulu la chinthu chogwira ntchito limamwa.

Saksagliptin alibe chizolowezi cholowa m'mapuloteni amwazi - mawonekedwe a maubwenzi awa amakhudza gawo laling'ono la chinthucho. Kuchuluka kwa mankhwalawa kumatheka mu maola pafupifupi awiri (ziwalo zamunthu zimakhudza izi). Zimatenga pafupifupi maola atatu kuti muchepetse theka la Saxagliptin lomwe likubwera.

Malangizo ogwiritsira ntchito Onglises: njira ndi mlingo

• Onglisa - 5 mg patsiku,
• Metformin - 500 mg patsiku.

Ngati zochita zosakwanira zadziwika, mlingo wa metformin uyenera kusintha, umachulukitsidwa.

Ngati, pazifukwa zilizonse, nthawi yakumwa mankhwalawo idasemphana, wodwalayo amwe mapiritsi ake mwachangu. Sikoyenera kuwirikiza kawiri mlingo wa tsiku ndi tsiku.

Kwa odwala omwe ali ndi matenda opatsika pang'ono aimpso, ndikofunikira kuti musinthe mwanjira ina. Ndi kusokonezeka kwa impso kwamitundu yozama komanso yozama ya owlis ayenera kumwedwa m'magawo ang'onoang'ono - 2,5 mg kamodzi patsiku.

Ngati hemodialysis ichitika, onglisa amatengedwa kumapeto kwa gawo. Zotsatira za saxagliptin pa odwala omwe akudwala peritoneal dialysis sizinafufuzidwebe. Chifukwa chake, musanayambe mankhwala ndi mankhwalawa, kuyenera kuchitika kwa impso kuyenera kuchitidwa.

Ndi vuto la chiwindi, kupezeka mwachindunji muyezo wake muyezo wotchulidwa - 5 mg patsiku. Zochizira odwala okalamba, zachidziwitso zimagwiritsidwanso ntchito chimodzimodzi. Koma tikumbukire kuti chiopsezo chokhala ndi kulephera kwa aimpso m'gulu lino la odwala matenda ashuga ndiwambiri.

Palibe ndemanga kapena kafukufuku wapadera wazomwe zimachitika chifukwa cha mankhwalawa kwa odwala ochepera zaka 18. Chifukwa chake, kwa achinyamata omwe ali ndi matenda a shuga a mtundu wachiwiri, ma fanizo omwe ali ndi chinthu china chogwira ntchito amasankhidwa.

Chifukwa chake, mlingo woyenera tsiku ndi tsiku ndi 2,5 mg.

Mukayamba kuphatikiza mankhwala ndi metformin, mlingo wake woyamba wa tsiku lililonse ndi 500 mg. Pankhani ya yankho losakwanira, iwonjezeke.

Ngati mlingo wa Onglisa wasowa, uyenera kumwedwa mwachangu, komabe, kawiri mlingo sayenera kumwa patatha maola 24.

Mlingo wa tsiku ndi tsiku kwa odwala omwe ali ndi kuchepa kwapakati / kupweteka kwambiri kwa aimpso (omwe ali ndi creatinine chilolezo cha 50 ml / min), komanso kwa odwala omwe ali ndi hemodialysis, ndi 2.5 mg mu 1 mlingo. Ongliz ayenera kumwedwa atatha gawo la hemodialysis.

Mlingo watsiku ndi tsiku wa Onglisa akaphatikizidwa ndi indinavir, nefazodone, ketoconazole, atazanavir, ritonavir, clarithromycin, itraconazole, nelfinavir, saquinavir, telithromycin ndi zoletsa zina zamphamvu za CYP 3A4 / 5 ndi 2.5 mg.

Zina zomwe muyenera kudziwa

Onglis sanalembedwe ndi insulin kapena mankhwala patatu ndi metformin ndi thiazolididones, popeza maphunziro a kuyanjana kwawo sanachitike. Ngati wodwala akudwala pang'ono komanso wamphamvu kulephera kwa impso, mlingo wa tsiku ndi tsiku uyenera kuchepetsedwa.

Zinakhazikitsidwa kuti zotumphukira za sulfanilurea zimatha kupangitsa hypoglycemia. Kuti mupewe chiopsezo cha hypoglycemia, mlingo wa sulfanilurea osakanikirana ndi chithandizo cha mankhwala osafunikira uyenera kusinthidwa. Ndiye kuti, kuchepetsedwa.

Ngati wodwala ali ndi mbiri ya hypersensitivity kwa zoletsa zilizonse zofanana za DPP-4, saxagliptin sichosankhidwa. Ponena za chitetezo ndi kuyenera kwa chithandizo cha odwala okalamba (opitilira zaka 6) ndi mankhwalawa, palibe machenjezo pankhaniyi. Onglisa amalekeredwa ndipo amachita chimodzimodzi ndi odwala achinyamata.

Popeza mankhwalawa ali ndi lactose, sioyenera kwa iwo omwe ali ndi vuto lodana ndi chinthuchi, kuperewera kwa lactose, glucose-galactose malabsorption.

Mphamvu ya mankhwalawa pa kuyendetsa magalimoto ndi zida zina zofunikira kwambiri kuti adziyang'anitsitse sizinaphunzire konse.

Palibe zotsutsana mwachindunji poyendetsa galimoto, koma ziyenera kukumbukiridwa kuti pakati pazotsatira zoyipa ndi kupweteka kwa mutu kumadziwika.