Mankhwala - Saksenda - wa kuwonda

Mankhwala Saxenda ndi hypoglycemic wothandizira pochiza kunenepa kwambiri kwa odwala okhala ndi cholozera cha mafuta pamwambapa 27. Zizindikiro zowonjezera zogwiritsira ntchito ndi mtundu wa 2 shuga (osadalira insulini), kuchepa kwa lipoprotein kagayidwe kakang'ono ndi kukweza magazi m'thupi.

Mankhwalawa apangidwa kuyambira 2015 ku Denmark ndi Novo Nordisk. Fomu yotulutsira imayimiriridwa ndi yankho (3 mg) ya subcutaneous makonzedwe, yoyikidwa mu cholembera. Kuti mugwiritse ntchito mosavuta, chida chimakhala ndi magawano, omwe amakupatsani mwayi wogawa chida ichi. Phukusi limodzi lili ndi ma syringe asanu.

Gawo lalikulu la mankhwala opangira mankhwala ndi liraglutide. Katunduyu ndi analogue yopanga mahomoni GLP-1 kapena glucagon-ngati peptide-1 (zomwe zimachitika mwanjira yachilengedwe ya 97%), yomwe imapangidwa ndi matumbo ndipo imakhudzanso zikondamoyo, zomwe zimapangitsa secretion ya insulin. Zothandizira zina ndi:

• phenol
• sodium hydrogen phosphate dihydrate,
• sodium hydroxide
• propylene glycol
• madzi a jakisoni.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Amapezeka mu mawonekedwe a yankho lomveka bwino la subcutaneous management. Mu phukusi la masentensi 5 a 3 ml.

• liraglutide (6 mg / ml),
• sodium hydrogen phosphate dihydrate,
• phenol
• propylene glycol
• hydrochloric acid / sodium hydroxide,
• madzi a jakisoni.

Zotsatira za pharmacological

Zotsatira zazikulu ndi kuwonda. Kuphatikiza apo kumakhala ndi vuto la hypoglycemic. Mukamamwa 3 mg ya liraglutide patsiku, kutsatira zakudya ndikuchita masewera olimbitsa thupi, pafupifupi 80% ya anthu amachepetsa thupi.

Liraglutide ndi analogue ya human peptide-1 (GLP-1), yomwe imapezeka ndi kubwezeretsanso kwa DNA. Imagwira ndikuyambitsa cholandirira china, chifukwa chomwe kunyowa kwa chakudya kuchokera m'mimba kumachepetsa, minofu ya adipose imachepa, chilakolako chimayendetsedwa, chimafooketsa chizindikiro cha njala. Mankhwala amathandizira kubisika kwa insulini, kuchepetsa kuchuluka kwa shuga. Nthawi yomweyo, pali kusintha kwa magwiridwe antchito a maselo a beta mu kapamba.

Pharmacokinetics

The mayamwidwe pang'onopang'ono, pazipita ndende ndi maola 11 pambuyo makonzedwe. Bioavailability ndi 55%.

Kupangika modogenous, palibe njira yodziwika yodziwira. Zinthu zina zimatuluka ndi mkodzo ndi ndowe. Kuchotsa hafu ya moyo kuchokera ku chamoyo kumapangitsa pafupifupi maola 12-13.

• Kunenepa kwambiri (kulemera kwa thupi zoposa 30), incl. chifukwa cha kusokonekera kwa shuga.
• Mtundu 2 wa shuga wambiri,
• Matenda oopsa
• Kunenepa kwambiri.
• Kuletsa kugona apnea syndrome (kunenepa kwambiri ngati zotsatira zoyipa).

Contraindication

• Hypersensitivity pamagawo ake,
• Zowononga kwambiri kapena kuwonongeka kwa chiwindi,
• Multiple endocrine neoplasia 2 mitundu,
• Mtima kulephera kwa III-IV magawo ogwirira ntchito,
• Mbiri yokhudza khansa ya chithokomiro ya medullary (banja kapena munthu payekha),
• Kugwiritsa ntchito munthawi yomweyo mankhwala ena kukonza thupi,
• Kunenepa kwambiri kwachiwiri chifukwa cha mavuto azakudya, matenda a endocrine, pogwiritsa ntchito mankhwala omwe amachititsa kuti munthu azikula,
• Ntchito mogwirizana ndi insulin
• Ana osakwana zaka 18
• Mimba komanso kuyamwa,
• Kukhumudwa kwambiri, mbiri yodzipha.

Malangizo ogwiritsira ntchito

Imaperekedwa pokhapokha, njira zina ndizoletsedwa. Mlingo amasankhidwa ndi adotolo.

Amagwiritsidwa ntchito kamodzi patsiku, jakisoni imachitika mosasamala chakudyacho. Jakisoni amatha kupaka m'mimba, m'chiuno, m'mapewa kapena matako. Tsamba la jakisoni liyenera kusinthidwa pafupipafupi. Ndikofunika kupereka jakisoni nthawi yomweyo.

Mlingo woyambirira ndi 0,6 mg patsiku. Pang'onopang'ono, amaloledwa kuwonjezeka mpaka 3 mg mkati mwa sabata. Ngati "mavuto" akuwoneka ndipo mlingo wake utakula, osachotsedwa, muyenera kusiya kumwa mankhwalawo.

Zotsatira zoyipa

Mndandanda wazotsatira zosafunikira ndizambiri:

• thupi lawo siligwirizana
• anaphylactic reaction,
• urticaria
• zimachitika malo jakisoni,
• asthenia, kutopa,
• nseru
• kamwa yowuma
• cholecystitis, cholelithiasis,
• pachimake aimpso kulephera, aimpso ntchito,
• kapamba
• kusanza
• dyspepsia
• kutsegula m'mimba
• kudzimbidwa
• kupweteka pamimba,
• gastritis
• chisangalalo
• gastroesophageal Reflux,
• kubwatula
• ukufalikira
• kusowa kwamadzi
• tachycardia
• kusowa tulo
• chizungulire
• dysgeusia,
• hypoglycemia mwa odwala matenda ashuga omwe amagwiritsa ntchito ma hypoglycemic othandizira ena.

Bongo

Zitha kuyambitsa bongo ngati mulandira mlingo waukulu kwambiri. Pankhaniyi, zizindikiro zotsatirazi zadziwika:

• nseru
• kusanza
• kutsegula m'mimba, nthawi zina kwambiri.

Chithandizo choyenera chimachitidwa kuti muchepetse zizindikiro. Onetsetsani kuti mwawonana ndi dokotala.

Zofunika! Panalibe milandu ya hypoglycemia chifukwa cha bongo.

Kuyanjana kwa mankhwala osokoneza bongo

Saksenda amalumikizana bwino ndi njira zina. Chifukwa cha kuchepa kwa mankhwala a m'mimba, kungakhudze mayamwidwe ena omwe mumagwiritsidwa ntchito, choncho gwiritsani ntchito mosamala pophatikiza mankhwala.

Chifukwa cha kusowa kwa deta yolondola pazomwe zimagwirizana ndi mankhwala ena, liraglutide sangathe kuphatikiza.

Omwe amagwiritsa ntchito warfarin ndi zotumphukira zina za coumarin ayenera kuyang'anira INR koyambirira kwa chithandizo cha Saxenda.

Odwala omwe ali ndi matenda ashuga sayenera kugwiritsidwa ntchito ndi insulin. Komanso sioyenera kukhala ndi monotherapy m'malo mwa insulin.

Malangizo apadera

Siligwiritsidwa ntchito ngati m'malo mwa insulin pochiza matenda a shuga.

Gwiritsani ntchito mosamala mwa anthu omwe ali ndi vuto la mtima. Pali chiopsezo chokhala ndi pancreatitis pachimake, pokhudzana ndi zomwe wodwalayo ayenera kudziwa zomwe akuwonetsa ndikufufuzidwa nthawi zonse. Zikakhala kuti zikuwonekera, kugonekedwa kuchipatala ndi kuchotseredwa mankhwala ndikofunikira.

Wodwala ayenera kudziwa kuopsa kokhala ndi matenda otsatirawa:

• cholecystitis ndi cholelithiasis,
• matenda a chithokomiro (mpaka khansa),
• tachycardia
• hypoglycemia mu matenda ashuga,
• kukhumudwa ndi mtima wofuna kudzipha,
• khansa ya m'mawere (palibe data yolondola yolumikizana ndi kapangidwe ka liraglutide, koma pali zochitika zamankhwala),
• colorectal neoplasia,
• mtima conduction zosokoneza.

Sizigwiritsidwa ntchito ngati umphumphu wa phukusi udasweka kapena yankho limawoneka losiyana ndi madzi omveka komanso opanda khungu.

Pang'onopang'ono zimakhudza kuyendetsa galimoto. Odwala omwe amagwiritsa ntchito Saxenda pophatikizira mankhwala a sulfonylurea amakulitsa chiopsezo cha hypoglycemia, chifukwa chake samalimbikitsidwa kuyendetsa galimoto kapena kugwiritsa ntchito njira zina zoopsa panthawi ya chithandizo.

Imatulutsidwa kokha pamankhwala!

Mbali yamankhwala

Chofunikira chachikulu pa mankhwala a Danish a Saksenda ndi liraglutide. Ndizofanana ndi gawo lomwe limapangidwa ndi matumbo.

Liraglutide amachepetsa njira yosunthira chakudya kuchokera m'mimba kupita m'munsi chimbudzi. Chifukwa cha izi, kumverera kwa kukomoka mutatha kudya kumatenga nthawi yayitali, ndipo kusilira kumachepa.

Kuchepetsa thupi mopanda chisoni kumachepetsa kuchuluka kwa zakudya zomwe zimamwa, zomwe zimathandiza kuchepetsa thupi mwachangu.

"Saksenda" samapanga zopanda pake kukonza zakudya, chakudya chochepa-zopatsa mphamvu chimafunikabe. Koma chifukwa cha mankhwalawa, sikuyenda limodzi ndi zovuta zopweteka za njala. Izi zimapangitsa kuti njira yochepetsera thupi isangokhala mwachangu, komanso, komanso yosakhumudwitsa dongosolo lamanjenje.

Tikupangira kuwerenga za owotcha mafuta kuti muchepetse kunenepa. Muphunzira za zachilengedwe (oatmeal, zipatso, buckwheat, ginger ndi ena) komanso kapangidwe (mapiritsi, zomata, zopopera) mafuta oyaka.
Ndipo izi ndizambiri za L-carnitine pakuchepetsa thupi.

Ndani ali woyenera

Mankhwala sangathe kugwiritsidwa ntchito motsutsana, kufuna kuyambitsa njira yochepetsera thupi. Amasankhidwa ndi katswiri pambuyo popenda bwino wodwalayo.

Chizindikiro chogwiritsidwa ntchito ndi cholozera cha misa chopitilira 27 mpaka 30 mayunitsi.

Zowonjezera zomwe zimamwa mankhwalawa ndi kuthamanga kwa magazi, cholesterol ndi yayikulu kuposa yachilendo, komanso matenda a shuga 2, omwe sagwiritsa ntchito insulin.

Chitetezo ndi luso

Asanalowe mumsika wamankhwala, Saksenda adadutsa mayesero angapo a labotale ndi zamankhwala. Maphunziro 4 adachitika. Mwa atatu mwa iwo, gulu loyang'anira lidagwiritsa ntchito mankhwalawa kwa masabata a 56. Wodwala woyamba adatenga miyezi yopitilira 2. Magulu a anthu adagawika malinga ndi mawonekedwe a zovuta zomwe zidalipo, koma zonsezo zidali zonenepa kwambiri.

Gawo la maphunziro omwe adagwiritsa ntchito mankhwalawa adachita bwino kwambiri pakuchepetsa thupi kuposa omwe adamwa. Kwa milungu 12, adatha kuchepetsa kulemera ndi 5% ya kulemera kwathunthu kwa thupi.

Kuphatikiza apo, kuchuluka kwa shuga m'magazi awo kunayamba kuyenda bwino, kuthamanga kwa magazi awo komanso kuchuluka kwa mafuta m'thupi kumakhazikika. Zidawululidwanso kuti Saksenda siliyakumwa poizoni, sizipangitsa kuti zotupa zikhudze ndipo sizikhudza ntchito yobereka.

Koma ndi chithandizo chake ndikotheka kusintha mkhalidwe wa kapamba.

Kusintha kwa kulemera kwa thupi kwa odwala mphamvu mukamamwa mankhwala "Saksenda" ndi placebo

Komabe, ndi zabwino zake zonse, mankhwalawa amatha kubweretsa zovuta. Nthawi zambiri chimadziwika:

• mseru ndi kusanza, kutsegula m'mimba,
• kamwa yowuma
• kupweteka m'mimba kapena matumbo, belching, flatulence,
• kufooka chifukwa cha kuchepa kwa shuga m'magazi, kutopa,
• kusowa tulo
• chizungulire.

Nthawi zina, pali:

• kapamba
• kuwonetsedwa kwa mziwopsezo patsamba la jakisoni kapena zina,
• kusowa kwamadzi
• tachycardia
• cholecystitis
• urticaria
• kuwonongeka kwaimpso,
• hypoglycemia mu diabetes ndi mtundu 2 matenda.

Zizindikiro zonse zosasangalatsa ziyenera kudziwitsidwa kwa dokotala. Ayenera kusankha kuti asiye kugwiritsa ntchito mankhwalawa kapena kusintha mlingo wokwanira.

Kuyambitsa "Saksenda"

Mankhwalawa amapezeka mu mawonekedwe a yankho, lomwe limayikidwa mu cholembera. Chifukwa chake, amalowetsedwa m'thupi. Jakisoni amachitidwa tsiku ndi tsiku pansi pa khungu m'matumbo, phewa kapena ntchafu, osagwirizana kudzera m'mitsempha. Ndikwabwino kugwiritsa ntchito mankhwalawa maola omwewo, osayiwala kusintha singano nthawi iliyonse ndi yatsopano.

Mlingo amawerengedwa ndi adokotala. Dongosolo lodziwika ndikuti chithandizo chimayamba ndi 0,6 mg patsiku, ndikuwonjezera 0,6 mg sabata iliyonse. Mlingo umodzi wokha wa Saksenda sayenera kupitirira 3 mg. Kuchuluka kwa mankhwalawa kumayendetsedwa ndi cholembera pa syringe. Mukayika singano pakhungu, muyenera kukanikiza batani ndipo musamamasule mpaka otsutsana ndi mlingo kuti mubwerere ku ziro.

Zomwe zili bwino - "Saksenda" kapena "Viktoza"

Liraglutide, yomwe imathandizira kuchepetsa kuchuluka kwa zakudya zomwe zimamwa, sikuti imapangidwa ku Saksenda kokha.

Ndiye gawo lalikulu lamankhwala "Victoza", omwe amapangidwa ndi kampani yomweyo. Koma mu chida ichi, kuchuluka kwa liraglutide ndiwokwera.

Chifukwa chake, mlingo wa Victoza wa tsiku ndi tsiku sayenera kupitirira 1.8 mg. Ndipo osagwiritsa ntchito kuwonda, koma kuti musinthe matenda a shuga a 2.

Ngati cholinga ndikukonza thupi, muyenera kutenga Saxenda. Amapangidwira makamaka kuwonda, ndipo sagwiritsidwa ntchito pochiza matenda ashuga.

Timalimbikitsa kuti muwerenge zamankhwala ochepetsa lipid. Muphunzira za momwe mungatengere mankhwala osokoneza bongo, gulu, mankhwala aposachedwa kwambiri okhala ndi lipid-kuchepetsa.
Ndipo nazi zambiri za Reduxin wa mankhwala ochepetsa thupi.

Ubwino wabwino wa Saxenda ndikuti pakutha kwa mphamvu yake, kulemera kwake sikuyambiranso kukula. Mukamagwiritsa ntchito chinthucho, m'mimba amabwerera kukula kwake.Wodwala samva kufunika kodya zakudya zochulukirapo kuposa momwe amathandizira.

Muyenera kokha kuwongolera zopatsa mphamvu mu chakudya.

Saksenda: malangizo ogwiritsira ntchito, mtengo, ndemanga ndi fanizo

Kunenepa kwambiri ndi vuto lomwe limatha kuchitika mwa munthu aliyense. Kulemera kwambiri kumakhudza thupi lonse, makamaka ngati ali ndi matenda oopsa. Pali njira zochizira matendawa. Chimodzi mwa izi ndi Saxenda. Ganizirani malangizo omwe mungagwiritse ntchito mankhwalawa mwatsatanetsatane.

Fananizani ndi fanizo

Saksenda ali ndi fanizo pakuphatikizika komanso kufanana kwa katundu ndi zotsatira zake. Ndikulimbikitsidwa kuti muzizolowera kuti muziyerekeza.

Victoza (liraglutide). Mankhwalawa amapangidwanso ndi Novo Nordisk, koma mtengo wake umakhala wotsika - kuchokera ku 9000 rubles. Zochita ndi kapangidwe kake ndizofanana ndi Saxend. Kusiyanaku kumangokhala mu ndende (pali mitundu ingapo) ndi dzina lina lazamalonda. Kutulutsa mawonekedwe - 3 ml syringe zolembera.

"Baeta" (exenatide). Imachepetsa m'mimba ndikuchepetsa chilako. Mtengo wake ndi wokwana ma ruble 10,000. Amapezeka mu ma syringe pens. Wopanga - "Eli Lilly Company". Oyenera kuchiza matenda a shuga, chifukwa ali ndi vuto la hypoglycemic, izi ndizomwe zimapangitsa, kuchepa thupi ndizowonjezera. Sizoletsedwa kwa amayi apakati ndi ana.

Forsiga (dapagliflozin). Amalepheretsa kuyamwa kwa shuga pambuyo podya, amachepetsa kuchuluka kwake m'thupi. Mtengo kuchokera ku 1800 rubles. Kampani yomwe imapanga mankhwalawa ndi Bristol Myers, Puerto Rico. Amapezeka piritsi. Musagwiritse ntchito pochiza ana osaposa zaka 18, amayi apakati ndi oyamwitsa, okalamba.

NovoNorm (repaglinide). Mankhwala a shuga. Kulimbitsa thupi ndi phindu linanso. Mtengo - kuchokera ku ma ruble a 180. Fomuyo ndi miyala. Amapanga kampani "Novo Nordisk", Denmark. Imagwira ntchito mwachangu komanso moyenera. Zotsatira zoyipa zambiri.

"Reduxin" (sibutramine). Makapisozi opangidwa pofuna kuchiza kunenepa kwambiri. Mtengo wa ma CD ndi ma ruble 1600. Kugwiritsa ntchito bwino kuchepetsa thupi, pomwe mankhwala amatha kuyambira miyezi itatu mpaka zaka ziwiri. Contraindations ambiri: osagwiritsa ntchito kuchitira amayi apakati, anthu ochepera 18 ndi zaka 65 zakubadwa.

"Diagninid" (repaglinide). Mapiritsi omwe amagwiritsidwa ntchito ngati hypoglycemic mwa anthu odwala matenda ashuga a 2. Mtengo uli pafupi ndi ma ruble 200 pamapiritsi 30. Mndandanda wa contraindication ndi wa ana komanso ukalamba, pakati komanso mkaka wa m'mawere. Amawerengera ngati chida chowonjezera pakudya ndi seti yolimbitsa thupi.

MTHANDIZO. Kugwiritsa ntchito kulikonse kwa analogue kumayikidwa ndi dokotala. Kudzipatsa nokha koletsedwa!

Nthawi zambiri anthu amati kuchepa thupi kumachitika, koma pokhapokha zakudya zovuta azitsatira komanso pali zolimbitsa thupi.

Andrei: “Ndimavutika ndi shuga komanso magazi. Adotolo adatuma Saksenda. Mankhwalawa ndiokwera mtengo kwambiri, koma, monga momwe zidakhalira, zothandiza. Kwa mwezi umodzi, shuga adayima pa 6.2 mmol / L, ndipo kulemera kwake kumachepera ndi 3 kg. Izi ndizotsatira zabwino kwambiri kwa ine. Ndipo thanzi langa lakhala bwino kwambiri. "Kulemera kwa chiwindi kunazimiririka, sindinapeze zomwe zimandichititsa kuti ndikhale wophunzitsika."

Galina: “Atatenga pakati, anayamba kulemera ku matenda ashuga. Dokotala adalamula chithandizo cha Saxenda. Panali zovuta zina mu mawonekedwe a chizungulire ndi mseru, koma pang'onopang'ono thupi limagwiritsidwa ntchito pamenepo, motero adachoka. Kulemera kumachoka pang'onopang'ono, pafupifupi makilogalamu 5 pamwezi, ndakhala ndikugwiritsa ntchito miyezi iwiri tsopano. Ndili wokondwa kuti ndikumva bwino. ”

Victoria: “Pakatha mwezi umodzi kuti amwe mankhwalawa, shuga amasungidwa pa 5.9 mmol / L. M'mbuyomu, zidakwera mpaka 12. Kuphatikiza apo, kulemera kwake kunachepa ndi 3 kg. Palibenso zowawa m'mapapo. Ndimatsata zakudya mosamalitsa, motero zimathandiza kumva zotsatira zake. Monga chilichonse kupatula mtengo wokwera. Koma zilibwino. ”

Pomaliza

Cholinga cha Saksenda pochiza matenda ashuga komanso kunenepa kwambiri ndi lingaliro la adotolo. Koma nthawi zambiri zimakhala zokhazikika.Anthu amazindikira kuti amakhutira ndi mankhwalawo, pomwe kukhalapo kwa zovuta sizofunikira. Chifukwa chake, mankhwalawa ali ndi mbiri yabwino pamsika wamankhwala.

Pokhapokha kunenepa kwambiri, kumapereka mavuto.

Mankhwala akuwonetsedwa kuti amachepetsa thupi chifukwa cha kunenepa kwambiri. Nthawi zambiri amatchulidwa kwa anthu omwe ali ndi matenda a shuga a mtundu wachiwiri. Jakisoni adapangira ma subcutaneous makonzedwe. Choyidacho chimayikidwa mu cholembera chapadera, chomwe chimakhala chosavuta kudzipeza nokha.

Ndidayamba makonzedwe ndi mlingo wa 0.6 mg, pang'onopang'ono ndikukula mpaka 1 mg. Zotsatira zake, ndidakumana ndi zovuta kuchokera m'mimba. Malangizowo akuwonetsa kuchitapo kanthu. Pambuyo pake adasiya kugwiritsa ntchito malonda. Kulemera (makilogalamu 3.6), omwe adapita m'milungu 1.5, adabweranso patatha masiku angapo.

Ndikufuna kuzindikira kuti zoyipa ndizotheka kuchokera ku ziwalo zonse ndi machitidwe. Ichi ndi mankhwala oopsa, osatetezeka.

Chothandizira chophatikizika ndi liraglutide.

Zotsatira zochepa kwambiri

Mankhwala amawoneka amakono kwambiri. Mu phukusi 5 syringe zolembera ndi madzi, voliyumu ya 3 ml. Kugwiritsa ntchito ndikosavuta. Ndinkapanga jakisoni m'mimba. Zilibe zopweteka, singano ndiyifupi komanso yochepa thupi. Wosanjikiza wamafuta pamimba unaphwanya ululu kuchokera pa jakisoni.

Pankhaniyi, zonse ndi zabwino komanso zopanda ululu. Ndapanga jakisoni woyamba wa 0,5 ml. Ndinayang'ana thupi momwe lingakhalire. Izi zisanachitike, zachidziwikire, adakumana ndi dokotala. Ndinalandila malangizo azachipatala pakugwiritsa ntchito mankhwalawa. Pambuyo pa sabata ndinakulitsa mlingo wa mankhwalawa, koma osachuluka.

Ndipo adayamba kuchepetsa kudya kwake. Panali malingaliro osamveka a njala pang'ono, koma sizinkawoneka kuti mankhwalawa mwanjira inayake adandithandiza kuthana nawo. Ntchito pafupifupi miyezi iwiri. Ndinkadzikakamiza kuti ndisiye chithandizo, koma zotsatira zake zinali zochepa. Kwa miyezi iwiri amataya 1.5 kg.

Izi sizokwanira ndi kulemera kwanga.

Ngakhale kutayika kwa makilogalamu 10 chifukwa chogwiritsa ntchito seramu imeneyi sikumandisangalatsa - ndinapeza zovuta zambiri pambuyo pake. Komabe, sindinadzizunze ndikutenga maphunziro a miyezi 3, koma kusiya, osafika kumapeto kwa mwezi woyamba.

Poyamba, ndizovuta kupanga jakisoni nokha, popanda maluso apadera. Mankhwala amayenera kuperekedwa mwachisawawa. Jekeseni woyamba 2 yemwe sindimatha kuyika molondola - zomwe zinali mu cholembera zinalowa mu minofu, zotumphukira, zomwe sizinathetse kwa nthawi yayitali.

Inde. Chovuta chachikulu ndikuti seramu imayenera kutumikiridwa mosamalitsa pa ndandanda, popanda nthawi yosowa, koma izi sizikhala nthawi zonse.

Patatha sabata limodzi ndikugwiritsa ntchito, ndidayamba kukhala ndi vuto la m'mimba, ndimatenda amisala, komanso kugona. Ndipo pakutha kwa mwezi adayamba kukhala wokhumudwa - zovuta zotere, mwa njira, zikuwonetsedwa mu malangizo. Chidwi chinatheratu, chinali kudwala kuchokera ku mtundu wa zinthu.

Pafupifupi, ndizovuta kwambiri ndi mankhwala, omwe, ndikuganiza, ndi oyenera ngati njira yomaliza yolimbana ndi kunenepa kwambiri.

Mankhwalawa adayendetsa mkhalidwe wokhumudwa kwambiri

Ndinkadzitonza ndekha, kubaya Saxenda, jekeseni, kwa mwezi umodzi. Ndipo ngakhale maphunzirowa ali miyezi itatu, ndinasiya njira iyi yoonda. Yoyambitsidwa ndi Mlingo wochepera wa 0,6 mg, kenako ukuwonjezeka mpaka 1.2 mg.

Zinali zosasangalatsa kuchita jakisoni, koma sizinadzetse zowawa zambiri. Ndidapitilira kudya, ndidayamba kuthamanga m'mawa, kuti ndikulimbikitse. Pambuyo pa masabata awiri, ndinali ndi nkhawa. Ndine chiyembekezo m'moyo, ndipo ndili ndi misozi pang'ono, zovuta zilizonse zazing'ono ndizopsinjika. Zinafika poti ndinapeza malingaliro okakamiza.

Ndi malingaliro awa ndidadzitengera ku hysteria.

Patatha mwezi umodzi, zotsatira zoyambirira zinaonekera, zinali zowonekeratu kuti mankhwalawa anali othandiza. Ndipo komabe ine ndinayima. M'mawa wotsatira ndidadzuka ngati munthu wachimwemwe, malingaliro onse osalaza adabalalika ndipo palibe chomwe chidasowa m'mutu mwanga.

Saxenda 6 mg / ml

Saksenda (liraglutide) 3 mg - mankhwala osokoneza bongo monga njira yothetsera kuwonda. Amawonjezera kuwonjezera pa zakudya ndi masewera olimbitsa thupi. Zimathandiza osati kuchepetsa kulemera, komanso kusunga zotsatira mtsogolo.

Mankhwala ovomerezeka ku United States kuti athandize anthu:

• ndi mndandanda wamankhwala opitilira 30 (kunenepa kwambiri),
• Ndi mndandanda wamankhwala owonjezera oposa 27 (onenepa kwambiri) ndi chimodzi mwazotsatira: matenda oopsa, matenda ashuga a 2, cholesterol yayikulu.

Yang'anani! Malinga ndi webusayiti yaopangayo (https://www.saxenda.com) Saxenda SIYONSE kuti agwiritse ntchito limodzi ndi Victoza kapena insulin! Sicholinga chake kuchitira matenda amtundu wa 2 shuga.

Saxenda ali ndi chinthu chofanana ndi Viktoza - liraglutid (liraglutid). Chifukwa chake, kugwiritsidwa ntchito kwake kopitilira kumabweretsa chidziwitso cha mankhwala.

Zotsatira zakuchipatala

Kutenga Saxenda (kuphatikiza zakudya ndi masewera olimbitsa thupi), odwala adataya pafupifupi ma kilogalamu 2,5 poyerekeza ndi placebo: pafupifupi, 7.8 ndi 3 kg, motsatana.

Zotsatira za chithandizo, 62% ya odwala omwe amamwa mankhwalawo adataya kuposa 5% ya kulemera koyamba, ndipo 34% - oposa 10%.

Zotsatira zazikulu za kumwa kwa Saxenda zimawonekera mu milungu 8 yoyambirira yamankhwala.

Malinga ndi zotsatira za kafukufuku wina, 80% ya odwala omwe adataya kuposa 5% ya kulemera kwawo m'milungu yoyamba yamankhwala samangokhala ndi zotsatira zomwe adapeza, koma adataya wina 6.8%.

Gulu la Nosological (ICD-10)

Mankhwala

The yogwira mankhwala Saksenda ® - liraglutide - ndi analog wa anthu glucagon-ngati peptide-1 (GLP-1), opangidwa ndi njira recombinant DNA biotechnology ntchito kupanikizana Saccharomyces cerevisiaeokhala ndi 97% ya Homology yotsatizana ya amino acid ku endo native human GLP-1. Liraglutide imamanga ndikuyambitsa ndi GLP-1 receptor (GLP-1P). Liraglutide imagwirizana ndi kusweka kwa metabolic, T yake_1/2 kuchokera plasma pambuyo s / c makonzedwe ndi maola 13. Mbiri ya pharmacokinetic ya liraglutide, kulola odwala kuyendetsa kamodzi patsiku, ndi chifukwa chodziyanjanitsa, chomwe chimapangitsa kuchepa kwa mankhwalawa, kumanga mapuloteni a plasma, komanso kukana dipeptidyl peptidase-4 (DPP) -4) ndi ndale endopeptidase (NEP).

GLP-1 ndi kayendetsedwe ka thupi ka kudya ndi kudya. GLP-1P idapezeka m'malo angapo aubongo omwe akukhudzidwa pakukhazikitsa chilimbikitso. M'maphunziro a zinyama, kuyendetsa liraglutide kunapangitsa kuti agwire malo ena a ubongo, kuphatikizapo hypothalamus, komwe liraglutide, kudzera mwa kutsegulira mwachindunji kwa GLP-1P, kuchulukitsa kwa siginecha komanso kufooketsa mphamvu zam'manja, potero kumapangitsa kutsika kwa thupi.

Liraglutide amachepetsa kulemera kwa thupi la munthu makamaka mwa kuchepetsa kuchuluka kwa minofu ya adipose. Kuchepetsa thupi kumachitika chifukwa chochepetsa chakudya. Liraglutide sichulukitsa mphamvu ya maola 24. Liraglutide imayendetsa chilimbikitso ndi kukulitsa kumverera kwadzaza kwam'mimba komanso kukhuta, kwinaku ikuchepetsa kumverera kwanjala ndikuchepetsa kudya komwe kumayembekezeredwa. Liraglutide imapangitsa kuti inshuwaransi isungunuke ndipo imachepetsa kubisalira kwakukulu kwa glucose m'njira yodalira glucose, komanso imathandizira ntchito ya maselo a pancreatic beta, omwe amatsogolera kuchepa kwa kusala kwa glucose mukatha kudya. Njira yochepetsera shuga ndende imaphatikizaponso kuchedwa pang'ono m'matumbo.

Pazoyeserera zam'chipatala zazitali zomwe zimaphatikizapo odwala omwe ali ndi kunenepa kwambiri kapena kunenepa kwambiri, kugwiritsa ntchito Saksenda ® kuphatikiza ndi zakudya zama calorie ochepa ndikuwonjezera zolimbitsa thupi kunapangitsa kutsika kwakukulu kwa thupi.

Zotsatira pakulakalaka, kudya calorie, mphamvu zamagetsi, kutsuka kwa m'mimba, komanso kusala komanso kutsokomola kwa glucose

Zotsatira zam'mapapo zamankhwala osokoneza bongo zomwe zimachitika liraglutide zidawerengedwa mu kafukufuku wamasabata 5 wokhudzana ndi odwala 49 onenepa (BMI - 30-40 kg / m 2) popanda matenda a shuga.

Kulakalaka, kudya calorie ndi kuwononga mphamvu

Amakhulupirira kuti kuchepa thupi pogwiritsa ntchito Saksenda ® kumalumikizidwa ndi kayendetsedwe kazakudya komanso kuchuluka kwa zopatsa mphamvu. Kulakalaka chakudya kunayesedwa asanachitike ndi chakudya cham'mawa 5, chakudya chopanda malire chinayesedwa pakudya kwamadzulo. Saksenda ® inakulitsa kumverera kwodzaza ndi nkhawa yonse yam'mimba mutatha kudya ndikuchepetsa kumverera kwanjala komanso kuchuluka kwa chakudya chongoyerekeza, komanso kuchepetsa zakudya zopanda malire poyerekeza ndi placebo. Mukayesedwa pogwiritsa ntchito chipinda chopumira, palibe owonjezera pakugwiritsa ntchito maola 24 ophatikizidwa ndi mankhwala.

Kugwiritsa ntchito kwa Saksenda ® kunayambitsa kuchepa kwakanthawi kwam'mimba m'mawa woyamba mutatha kudya, zomwe zimapangitsa kutsika kwa kuchuluka kwa ndende, komanso kuchuluka kwa shuga wamagazi atatha kudya.

Kuzungulira kwa shuga, insulin ndi glucagon pamimba yopanda kanthu ndikatha kudya

The kuchuluka kwa shuga, insulin ndi glucagon pamimba yopanda kanthu ndipo atatha kudya anayesedwa asanachitike ndi mkati mwa maola 5 mutatha chakudya chokhazikika. Poyerekeza ndi placebo, Saxenda ® idachepetsa kusala komanso kuchuluka kwa shuga m'magazi (AUC_{0-60 min}) paola loyamba mutatha kudya, komanso kuchepetsa shuga wa maola 5 AUC ndikukulitsa kuchuluka kwa glucose (AUC_{0-300 min}) Kuphatikiza apo, Saxenda ® idachepetsa postprandial glucagon concentration (AUC_{0-300 min} ) ndi insulin (AUC_{0-60 min}) ndikuwonjezera insulin ndende (iAUC_{0-60 min}) mutatha kudya poyerekeza ndi placebo.

Kusala komanso kuchuluka kwa glucose komanso kutsata kwa insulini kunayesedwanso panthawi yoyeserera pakamwa pa glucose (PTTG) ndi shuga wa 75 g isanachitike komanso pambuyo pa chaka cha 1 cha chithandizo kwa odwala 3731 omwe ali ndi kunenepa kwambiri komanso kulekerera shuga. Poyerekeza ndi placebo, Saxenda ® inachepetsa kusala komanso kukwera kwa glucose. Zotsatira zake zimatchulidwa kwambiri kwa odwala omwe ali ndi vuto la shuga. Kuphatikiza apo, Saksenda ® idachepetsa kusala kudya ndikukulitsa kuchuluka kwa insulin poyerekeza ndi placebo.

Zotsatira zakusala komanso kuchuluka kwa kutsata kwa shuga mwa odwala omwe ali ndi matenda a shuga 2 kapena onenepa kwambiri

Saksenda ® idachepetsa glucose wothamanga komanso kuchuluka kwakukula kwa gluprose (mphindi 90 mutatha kudya, mtengo wofunikira wa zakudya zitatu patsiku) poyerekeza ndi placebo.

Pancreatic beta cell ntchito

Kuyesedwa kwa zamankhwala kwa chaka chimodzi pogwiritsa ntchito Saxenda ® odwala omwe ali ndi kunenepa kwambiri kapena kunenepa kwambiri komanso opanda matenda a shuga awonetsa kusintha ndikusunga chida cha pancreatic beta cell pogwiritsa ntchito njira zoyezera monga homeostatic beta function test example -mawu (NOMA-B) ndi kuchuluka kwa kutsata kwa proinsulin ndi insulin.

Kuchita Mwachipatala ndi Chitetezo

Kuchita bwino komanso chitetezo cha Saxenda ® kukonza kwakanthawi kochepa thupi kuphatikiza zakudya zamagulu ocheperako komanso kuwonjezera zolimbitsa thupi kunaphunziridwa m'mayesero 4 osasankhidwa, akhungu awiri, oyesedwa ndi placebo (mayesero atatu a masabata a 56 ndi yesero limodzi la masabata 32). Maphunzirowa anali ndi odwala 5358 omwe ali m'magulu anayi osiyanasiyana: 1) odwala omwe ali ndi kunenepa kwambiri kapena onenepa kwambiri, komanso ndi amodzi mwa zinthu izi: Matenda operewera kwa glucose, matenda oopsa, matenda oopsa, 2) odwala omwe ali ndi kunenepa kwambiri kapena onenepa kwambiri. Ndi mtundu 2 wa shuga wolephera (HbA phindu_1c m'magawo 7 mpaka 10%), isanayambike kafukufukuyu kuti akonze HbA_1c odwala omwe amagwiritsidwa ntchito: zakudya ndi masewera olimbitsa thupi, metformin, sulfonylurea, glitazone yekha kapena kuphatikiza kulikonse, 3) odwala onenepa kwambiri omwe ali ndi vuto lotha kuchepera kapena kwambiri, 4) odwala omwe ali ndi kunenepa kwambiri kapena onenepa kwambiri komanso omwenso amakumana ndi matenda oopsa kapena dyslipidemia, omwe akwaniritsa kuchepa kwa thupi osachepera 5% ndi zakudya zochepa zopatsa mphamvu.

Kuchepa kwambiri kwa thupi kunakwaniritsidwa mwa odwala omwe ali ndi kunenepa kwambiri / onenepa kwambiri omwe adalandira Saksenda ® poyerekeza ndi odwala omwe adalandira placebo m'magulu onse ophunziridwa, kuphatikiza kupezeka kapena kusapezeka kwa vuto la glucose lotupa, lembani matenda ashuga a 2, komanso ziphuphu zakumaso kapena zovutitsa.

Pakuwerenga 1 (odwala omwe ali ndi kunenepa kwambiri komanso onenepa kwambiri, kulolerana ndi glucose kapena osavutikira), kuchepa thupi kunali 8% mwa odwala omwe amathandizidwa ndi Saksenda ® poyerekeza ndi 2.6% pagulu la placebo.

Mu kafukufuku 2 (odwala onenepa komanso onenepa kwambiri omwe ali ndi matenda amtundu wa 2), kuchepa thupi kunali 5.9% mwa odwala omwe adachitidwa ndi Saksenda ®, poyerekeza ndi 2% pagulu la placebo.

Mu Phunziro 3 (odwala onenepa komanso onenepa kwambiri omwe ali ndi ziphuphu zakukhazikika), kuchepa thupi kunali 5.7% mwa odwala omwe adachitidwa ndi Saksenda ®, poyerekeza ndi 1.6% pagulu la placebo.

Mu kafukufuku wachinayi (odwala omwe ali ndi kunenepa kwambiri komanso onenepa kwambiri atatha kuchepetsa thupi osachepera 5%), kutsika kowonjezereka kwa thupi kunali 6.3% mwa odwala omwe adachitidwa ndi Saksenda ®, poyerekeza ndi 0,2% pagulu la placebo. Mu kafukufuku wachinayi, odwala ambiri adasungabe kuchepa kwa thupi komwe kumachitika asanalandire chithandizo ndi Saksenda ® poyerekeza ndi placebo (81.4% ndi 48.9%, motsatana).

Kuphatikiza apo, m'magawo onse omwe aphunziridwa, odwala ambiri omwe amalandila Saxenda ® adapeza kuchepa kwa thupi osaposa 5% ndi oposa 10% poyerekeza ndi odwala omwe akulandira placebo.

Pakuwerenga 1 (odwala omwe ali ndi kunenepa kwambiri komanso onenepa kwambiri osalolera shuga wambiri), kuchepa kwa thupi kosachepera 5% pa sabata la 56 la zamankhwala adawonedwa mu 63,5% ya odwala omwe amalandila Saxenda ®, poyerekeza ndi 26.6% pagulu la placebo. Chiwerengero cha odwala omwe kuchepa kwa thupi masabata a 56 amathandizira mpaka 10% ndi 32.8% pagulu la odwala omwe amalandila Saksenda ®, poyerekeza ndi 10.1% pagulu la placebo. Ponseponse, kuchepa kwa thupi kunachitika pafupifupi 92% ya odwala omwe amalandila Saxenda ®, poyerekeza ndi pafupifupi 65% pagulu la placebo.

Chithunzi 1. Kusintha kwa kulemera kwa thupi (%) mumphamvu poyerekeza ndi mtengo woyambirira wa odwala omwe ali ndi kunenepa kwambiri kapena onenepa kwambiri kapena wopanda vuto la shuga.

Kuchepetsa thupi pambuyo pa milungu 12 ya mankhwala ndi Saxenda ®

Odwala omwe amayankhidwa poyambira kuchipatala adatchulidwa kuti ndi odwala omwe adapeza kuchepa kwa thupi osachepera 5% pambuyo pa milungu 12 ya mankhwala (masabata 4 a kuchuluka kwa mankhwalawa ndi masabata a 12 a chithandizo cha 3 mg).

M'maphunziro awiri (odwala omwe ali ndi kunenepa kwambiri kapena onenepa kwambiri osakhala ndi mtundu wa 2 shuga), 67.5 ndi 50.4% ya odwala adapeza kuchepa kwa thupi osachepera 5% pambuyo pa milungu 12 atathandizidwa.

Ndi mankhwala omwe anapitilizidwa ndi Saksenda ® (mpaka chaka chimodzi), 86.2% mwa odwala adapeza kuchepa kwa thupi osachepera 5% ndi 51% - osachepera 10%. Kutsika kwapakati pa kulemera kwa thupi mwa odwala omwe amaliza kafukufukuyu kunali 11.2% poyerekeza ndi mtengo woyamba. Mwa odwala omwe adakwaniritsa kuchepa kwa thupi osachepera 5% pambuyo pa masabata 12 ochiritsira pamtundu wa 3 mg ndikumaliza kafukufukuyo (chaka 1), kutsika kwakukulu kwa thupi kunali 3.8%.

Mankhwala a Saksenda ® amathandizira kwambiri kupindulitsa kwa glycemic mu subpopulations ndi standardoglycemia, kulolerana kwa glucose (kuchepa kwapakati kwa HbA_1s - 0,3%) ndi mtundu 2 shuga mellitus (kutsika kwapakati pa HbA_1c - 1.3%) poyerekeza ndi placebo (kutsika kwapakati pa HbA_1c - 0,1 ndi 0,4% motsatana). Pakufufuza komwe kumapangitsa odwala omwe ali ndi vuto loleza shuga, lembani mtundu wachiwiri wa matenda ashuga womwe umapangidwa mwa ochepa omwe amalandila Saxenda ® poyerekeza ndi gulu la placebo (0,2 ndi 1.1%, motsatana). Mwa kuchuluka kwakukulu kwa odwala omwe ali ndi vuto loleza shuga, kusintha kosinthika kwa vutoli kumawonedwa poyerekeza ndi gulu la placebo (69,2 ndi 32.7%, motsatana).

Pakafukufuku wokhudza odwala omwe ali ndi matenda ashuga a mtundu wa 2, 69.2 ndi 56.5% ya odwala omwe adachitidwa ndi Saksenda ® adapeza phindu la HbA_1s ® kuchepa kwakukulu kwa kuthamanga kwa magazi (ndi 4.3 motsutsana ndi 1.5 mfundo), abambo (okhala ndi 2.7 motsutsana ndi 1.8 mfundo), gawo lozungulira (pofika 8.2 kutalika kwa 4 cm) komanso kusintha kwakukulu pakupangika kwamapazi a lipid (kuchepa kwathunthu Chs mwa 3.2 motsutsana ndi 0,9%, kuchepa kwa LDL ndi 3.1 kutengera 0.7%, kuchuluka kwa HDL ndi 2.3 motsutsana ndi 0.5%, kuchepa kwa triglycerides ndi 13.6 motsutsana ndi 4.8%) poyerekeza ndi placebo.

Mukamagwiritsa ntchito Saksenda ®, panali kuchepa kwakukulu poyerekeza ndi placebo pakuvuta kwa ziphuphu zakumaso, zomwe zimayesedwa ndi kuchepa kwa apnea-hypnoea index (YAG) ndi milandu ya 12,2 ndi 6.1 pa ola limodzi.

Popeza mphamvu za immunogenic zomwe zimatha kukhala ndi mapuloteni komanso peptide, odwala amatha kupanga ma antibodies kupita ku liraglutide atatha chithandizo ndi Saxenda ®. M'maphunziro azachipatala, 2.5% ya odwala omwe amathandizidwa ndi Saxenda ® adapanga ma antibodies a liraglutide. Kupanga kwa ma antibodies sikunachepetse mphamvu ya mankhwalawa Saksenda ®.

Kuunika kwamtima

Zochitika zovuta pamtima (MALUNGU) adawunikiridwa ndi gulu la akatswiri odziimira pawokha komanso lotanthauzidwa ngati losavulala myocardial infarction, sitiroko lomwe silinaphe ndi kufa chifukwa cha matenda amtima. M'mayeso onse azachipatala a nthawi yayitali pogwiritsa ntchito mankhwala a Saksenda ® adadziwika 6 Mace mwa odwala omwe amalandira Saksenda ®, ndi 10 Mace - omwe alandira placebo. Chiwopsezo chowopsa ndi 95% CI poyerekeza Saxenda ® ndi placebo anali 0.31 0,1, 0,92. M'mayesero azachipatala a gawo lachitatu, kuwonjezeka kwa kugunda kwa mtima ndi 2,5 kumenyedwa pamphindi (kuchokera pa 1.6 mpaka 3.6 kumenyedwa pamphindi m'maphunziro amodzi) zimawonedwa mwa odwala omwe amalandira Saksenda ®. Kuwonjezeka kwakukulu kwa kugunda kwa mtima kunawonedwa pambuyo pa 6 milungu yothandizira. Kukula kumeneku kunasinthidwa ndikusowa pambuyo pakuchotsedwa kwa mankhwala a liraglutide.

Zotsatira za Odwala

Saksenda ® poyerekeza ndi zotsatira za placebo zimasintha zomwe zimatsimikizika kwa odwala pazowonetsa payekha. Kusintha kwakukuru kunawonekera pakuwunika kwafunso lonse losavuta pamafunso a thupi (IWQoL-Lite) ndi miyeso yonse yofunsa mafunso yoyesa moyo wabwino SF-36, zomwe zikuwonetsa kukhudzidwa kwabwino kwamthupi ndi m'malingaliro aumoyo wamoyo.

Deta Yotetezera

Zambiri zam'mbuyomu zochokera kumaphunziro a chitetezo cha mankhwala, kawopsedwe wa kawopsedwe ndi genotoxicity sizinawonetse vuto lililonse kwa anthu.

M'maphunziro a 2 a carcinogenicity mu makoswe ndi mbewa, zotupa za chithokomiro cha C zimapezeka zomwe sizinaphe. Mlingo wopanda poizoni (NOAEL) osati kukhazikitsidwa ndi makoswe. M nyani amalandira chithandizo kwa miyezi 20, zotupa izi sizinawoneke. Zotsatira zomwe zidapezedwa mu kafukufuku wama makoswe zimachitika chifukwa choti makoswe amamva kwambiri makina omwe si a genotoxic eniake omwe amaphatikizidwa ndi GLP-1 receptor. Tanthauzo la zomwe zimapezeka kwa anthu ndizotsika, koma sizingasiyidwe konse. Maonekedwe a neoplasms ena omwe amaphatikizidwa ndi mankhwalawa sanadziwike.

Kafukufuku wazinyama sanawonetse chovuta cha mankhwalawa chonde, koma pakhala chiwonjezeko chambiri mu pafupipafupi cha kufa koyambirira kwa embryonic mukamagwiritsa ntchito Mlingo wapamwamba kwambiri wa mankhwalawa.

Kukhazikitsidwa kwa liraglutide pakati pa nthawi ya phwando kunapangitsa kuchepa kwa thupi la amayi ndi kukula kwa fetal ndikosadziwika bwino konse mu nthiti mu makoswe, ndi mu akalulu, kupatuka kwamapangidwe a mafupa. Kukula kwa akhanda mu makoswe kunachepetsedwa munthawi ya mankhwalawa liraglutide, ndipo kuchepa kumeneku kunapitilira pambuyo poyamwitsa gulu lomwe limalandira mankhwala ambiri. Sizikudziwika zomwe zinayambitsa kuchepa kotereku kwa makoswe obadwa kumene - kuchepa kwa chakudya cha calorie ndi anthu oyembekezera kapena kuwonetsa mwachindunji kwa GLP-1 pa mwana wosabadwa / wakhanda.

Zizindikiro Saksenda ®

Kuphatikiza pa zakudya zama calorie ochepa ndikuwonjezera zochitika zolimbitsa thupi kwa nthawi yayitali kuti muthandize kukonza odwala omwe ali ndi BMI: ≥30 kg / m 2 (kunenepa kwambiri kapena ≥27 kg / m 2 ndi 2 (onenepa kwambiri) ngati alipo matenda amodzi omwe amaphatikizidwa ndi kunenepa kwambiri (monga kufooka kwa glucose, matenda ashuga a 2, matenda oopsa, matenda oopsa, kapenanso kugona chifukwa cha kugona).

Mimba komanso kuyamwa

Zambiri pakugwiritsa ntchito kwa Saksenda ® mwa amayi apakati ndizochepa. Kafukufuku wazinyama awonetsa kawopsedwe kabwino (onani Deta Yotetezera) Chiwopsezo chomwe chilipo kwa anthu sichikudziwika.

Kugwiritsa ntchito mankhwala Saksenda ® pa nthawi ya pakati kumatsutsana. Mukakonzekera kapena kukhala ndi pakati, chithandizo chamankhwala ndi Saksenda ® chiyenera kuyimitsidwa.

Sizikudziwika ngati liraglutide imadutsa mkaka wa m'mawere wa anthu. Kafukufuku wazinyama adawonetsa kuti kulowa kwa liraglutide ndi metabolites zokhudzana ndi mawonekedwe ake mu mkaka wa m'mawere ndizochepa. Kafukufuku wamtsogolo awonetsa kuchepa kwakukhazikika pokhudzana ndi zamankhwala pakukula kwa makoswe obadwa kumene (onani Deta Yotetezera) Chifukwa cha kusowa kwa chidziwitso, Saksenda ® imatsutsana panthawi yoyamwitsa.

Kuchita

Mu vitro kugwiritsa ntchito mankhwala. Kuchepa kotsika kwambiri kwa liraglutide mogwirizana ndi kuphatikiza kwa pharmacokinetic ndi zinthu zina zogwira ntchito kunawonetsedwa, chifukwa cha kagayidwe kazinthu mu cytochrome P450 system (CYP) komanso kumangiriza mapuloteni am'magazi.

Mu vivo kuyanjana kwa mankhwala osokoneza bongo. Kuchepetsa pang'ono m'matumbo mukamayamwa liraglutide kumatha kuyambitsa kuyamwa kwa munthawi yomweyo kugwiritsa ntchito mankhwala opaka pakamwa.Kafukufuku wolumikizana sanawonetse kuchepa kwakanthawi kachuma, kotero kusintha kwa mankhwala sikofunikira.

Maphunziro ochita mogwirizana anachitika pogwiritsa ntchito liraglutide pa mlingo wa 1.8 mg. Zotsatira zam'minyewa ya m'mimba zinalinso chimodzimodzi pogwiritsa ntchito liraglutide pa mlingo wa 1.8 mg ndi 3 mg (AUC_{0-300 min} paracetamol). Odwala angapo omwe amathandizidwa ndi liraglutide anali ndi gawo limodzi la matenda otsekula m'mimba.

Kutsekula m'mimba kumatha kuthana ndi mayamwa a concomitant oral.

Warfarin ndi zotumphukira zina za coumarin. Palibe maphunziro ochitapo kanthu omwe adachitapo. Zokhudzana kwambiri ndi mgwirizano wachilengedwe ndi zinthu zochepa zomwe zimakhala zosakwanira kapena chocheperako chothandizira, monga warfarin, sizingasiyidwe. Pambuyo poyambitsa chithandizo ndi Saxenda ® odwala omwe amalandila warfarin kapena zotumphukira zina, kuwongolera pafupipafupi kwa MHO kumalimbikitsidwa.

Paracetamol (acetaminophen). Liraglutide sanasinthe chiwonetsero chonse cha paracetamol patatha gawo limodzi la 1000 mg. C_max paracetamol idachepetsedwa ndi 31% ndi Median T_max kuchuluka ndi mphindi 15 Kusintha kwa Mlingo wothandizirana ndi paracetamol sikufunika.

Atorvastatin. Liraglutide sanasinthe chiwonetsero chonse cha atorvastatin pambuyo pa mlingo umodzi wa atorvastatin 40 mg. Chifukwa chake, kusintha kwa atorvastatin pamene agwiritsidwa ntchito limodzi ndi liraglutide sikofunikira. C_max atorvastatin adachepetsedwa ndi 38%, ndipo wapakatikati T_max kuchuluka kuchokera 1 mpaka 3 maola ntchito liraglutide.

Griseofulvin. Liraglutide sanasinthe chiwonetsero chonse cha griseofulvin atagwiritsa ntchito limodzi mlingo wa griseofulvin 500 mg. C_max griseofulvin adakulitsidwa ndi 37%, ndipo wapakatikati T_max sanasinthe. Kusintha kwa Mlingo wa griseofulvin ndi mankhwala ena okhala ndi mphamvu yochepa yoyambira komanso kulowa kwambiri sikofunikira.

Digoxin. Kugwiritsa ntchito mlingo umodzi wa 1 mg digoxin osakanikirana ndi liraglutide kunapangitsa kutsika kwa AUC kwa digoxin ndi 16%, kuchepa kwa C_max pofika 31%. Median T_max kuchuluka kuchokera ku maola 1 mpaka 1.5. Kutengera ndi izi, kusintha kwa digoxin sikofunikira.

Lisinopril. Kugwiritsa ntchito mlingo umodzi wa lisinopril 20 mg wophatikizika ndi liraglutide kunapangitsa kutsika kwa 15% ku AUC ya lisinopril, kuchepa kwa C_max ndi 27%. Median T_max lisinopril inachuluka kuchokera maola 6 mpaka 8. Kutengera zotsatira izi, kusintha kwa mankhwalawa kwa lisinopril sikofunikira.

Njira zakulera za m'mimba za m'mimba. Liraglutide inachepetsa C_max ethinyl estradiol ndi levonorgestrel ndi 12 ndi 13%, motero, atagwiritsa ntchito limodzi mlingo wa mankhwala apakati a mahomoni. T_max Mankhwala onse omwe amagwiritsidwa ntchito ndi liraglutide achulukitsidwa ndi maola 1.5. Panalibe zovuta zamankhwala pakukhudzidwa kwachilengedwe kwa ethinyl estradiol kapena levonorgestrel. Chifukwa chake, zotsatira za kulera zimachitika mosayembekezereka pamene zimaphatikizidwa ndi liraglutide.

Kusagwirizana. Zinthu zamafuta zomwe zimawonjezeredwa ku Saksenda ® zimatha kuyambitsa kuwonongeka kwa liraglutide. Chifukwa chosowa maphunziro othandizira, mankhwalawa sayenera kusakanikirana ndi mankhwala ena.

Mlingo ndi makonzedwe

P / c. Mankhwala sangathe kulowa / mkati kapena / m.

Mankhwala Saxenda ® amathandizidwa kamodzi patsiku nthawi iliyonse, mosasamala kanthu za kudya. Iyenera kuperekedwa pamimba, ntchafu, kapena phewa. Malo ndi nthawi ya jakisoni itha kusinthidwa popanda kusintha kwa mlingo. Komabe, ndikofunikira kupaka jakisoni pafupifupi nthawi yomweyo masana mutasankha nthawi yabwino kwambiri.

Mlingo Mlingo woyamba ndi 0,6 mg / tsiku. Mlingo ukuwonjezeka mpaka 3 mg / tsiku, ndikuwonjezera 0,6 mg mosapumira kwa sabata limodzi kuti musinthe kulekerera kwam'mimba (onani tebulo).

Ngati, ndi kuchuluka kwakakulirakulira, watsopano sakuvomerezedwa ndi wodwalayo kwa masabata awiri otsatizana, kusiya kwa chithandizo chamankhwala kuyenera kuganiziridwanso. Kugwiritsa ntchito mankhwalawa tsiku lililonse kuposa 3 mg sikulimbikitsidwa.

Mankhwala a Saxenda® ayenera kusiyidwa ngati, atatha masabata 12 ogwiritsa ntchito mankhwalawa 3 mg / tsiku, kuchepa kwa thupi kunali kosakwana 5% ya mtengo woyambira. Kufunika kopitilira mankhwala kuyenera kuwunikiridwa chaka chilichonse.

Mlingo wosowa. Wopanda maola 12 atadutsa kale mankhwala, wodwalayo ayenera kupereka yatsopano posachedwa. Wotsalira ngati maola 12 asanakwane nthawi yotsatira, wodwala sayenera kulowa mu gawo lomwe walowa, koma ayenera kupitilizanso kumwa mankhwalawo. Osatulutsa mlingo wowonjezera kapena wowonjezera kuti ulipirire zomwe wasowa.

Odwala omwe ali ndi matenda ashuga a 2. Saksenda ® sayenera kugwiritsidwa ntchito limodzi ndi ena a GLP-1 receptor agonists.

Kumayambiriro kwa mankhwalawa ndi Saksenda ®, tikulimbikitsidwa kuti muchepetse mlingo wa omwe amagwiritsidwa ntchito nthawi yomweyo insulin secretagogues (monga sulfonylureas) kuti muchepetse chiopsezo cha hypoglycemia.

Magulu apadera a odwala

Odwala okalamba (zaka ≥65). Kusintha kwa Mlingo malinga ndi zaka sikofunikira. Zambiri pakugwiritsa ntchito mankhwalawa odwala azaka zapakati pa 75 ndi ochepa, ndikofunikira kugwiritsa ntchito mankhwalawa mosamala.

Kulephera kwina. Odwala omwe ali ndi vuto lofooka kapena locheperako (a forminine Cl ≥30 ml / min), kusintha kwa mlingo sikofunikira. Palibe chidziwitso chochepa pakugwiritsa ntchito Saksenda ® kwa odwala omwe amawonongeka kwambiri aimpso (Cl creatinine ® mwa odwalawa, kuphatikiza odwala omwe ali ndi vuto loti aimpopi amalephera.

Kuwonongeka kwa chiwindi. Odwala ndi mkhutu chiwindi ntchito ofatsa kapena zolimbitsa mwamphamvu, kusintha kwa mankhwala sikofunikira. Odwala ndi mkhutu chiwindi ntchito ofatsa kapena zolimbitsa zovuta, mankhwala ayenera kugwiritsidwa ntchito mosamala. Kugwiritsidwa ntchito kwa mankhwala Saksenda ® odwala omwe ali ndi vuto la chiwindi ndi otsutsana.

Ana. Kugwiritsa ntchito kwa mankhwala Saksenda ® mwa ana ndi achinyamata osakwana zaka 18 kumatsutsana popanda kusungidwa kwa chitetezo chokwanira.

Malangizo kwa odwala pakumwa mankhwala a Saksenda ® njira yothetsera kukonzekera kwa 6 mg / ml mu cholembera chodzaza ndi syringe

Musanagwiritse ntchito cholembera chodzaza ndi Saxenda ®, muyenera kuwerengera malangizo awa mosamala.

Gwiritsani ntchito cholembera pokhapokha wodwala atatha kugwiritsa ntchito motsogozedwa ndi dokotala kapena namwino.

Onani cholembera pa cholembera cholembera kuti mutsimikizire kuti ili ndi Saxenda ® 6 mg / ml, kenako phunzirani mosamala zithunzi zomwe zikuwonetsedwa, zomwe zikuwonetsa tsatanetsatane wa cholembera ndi singano.

Ngati wodwala ali ndi vuto la khungu kapena ali ndi vuto lalikulu lakuwona, ndipo sangathe kusiyanitsa manambala omwe ali pakompyutayo, musagwiritse ntchito cholembera popanda thandizo. Munthu wopanda zowonongeka, wophunzitsidwa bwino kugwiritsa ntchito cholembera chodzaza ndi Saksenda ®, atha kuthandiza.

Cholembera chodzaza chisanadze chili ndi 18 mg ya liraglutide ndipo chimakulolani kusankha mlingo wa 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg ndi 3.0 mg. Phata la syxinge ya Saxenda ® idapangidwa kuti igwiritsidwe ntchito ndi singano zotayika NovoFayn ® kapena NovoTvist ® mpaka 8 mm kutalika. Zingano sizikuphatikizidwa mu phukusi.

Chidziwitso chofunikira. Samalani zidziwitso zolemba chofunikira, izi ndizofunikira kuti cholembera chisagwiritsidwe.

Cholembera chodzaza chisanadze ndi Saxenda ® ndi singano (mwachitsanzo).

Ine.Kukonzekera cholembera ndi singano kuti mugwiritse ntchito

Chongani dzina ndi mtundu wa zilembo pa cholembera cholembera kuti mutsimikizire kuti ili ndi Saksenda ®.

Izi ndizofunikira kwambiri ngati wodwalayo akugwiritsa ntchito mitundu yosiyanasiyana ya jakisoni. Kugwiritsa ntchito mankhwala olakwika kungavulaze thanzi lake.

Chotsani chipewa mu syringe cholembera (mkuyu. A).

Onetsetsani kuti yankho mu syringe cholembera likuwonekera komanso lopanda utoto (mkuyu. B).

Onani pazenera pamiyeso yotsala. Ngati mankhwalawo ndi mitambo, cholembera sichingagwiritsidwe ntchito.

Tengani singano yatsopano yotaya ndikuchotsa chomata chomata (mkuyu. C).

Ikani singano pa cholembera ndi kuyitembenuza kuti singano ikhale bwino pang'onopang'ono pa cholembera (mkuyu. D).

Chotsani thumba lakunja la singano, koma osataya (mkuyu. E). Zidzafunika mukamaliza jakisoni kuti muchotsere singano bwinobwino.

Chotsani ndikutaya singano kapu yamkati (mkuyu. F). Wodwalayo akafuna kubwezeretsa singano yamkati pabowo, amatha kudulidwa. Dontho la yankho litha kuwoneka kumapeto kwa singano. Izi zimachitika mwanjira inayake, wodwalayo amayenera kuyang'anitsitsa kuchuluka kwa mankhwalawa ngati cholembera chatsopano chakhala chikugwiritsidwa ntchito koyamba. Singano yatsopano siyenera kuphatikiza mpaka wodwala atakonzeka kupanga jakisoni.

Chidziwitso chofunikira. Nthawi zonse gwiritsani ntchito singano yatsopano ya jekeseni iliyonse kuti mupewe kufalikira kwa singano, matenda, matenda ndi kubweretsa mankhwala olakwika. Osamagwiritsanso ndi singano ngati yakunga kapena yowonongeka.

II. Kuyang'ana kulandila mankhwalawo

Pamaso pa jekeseni woyamba, gwiritsani ntchito cholembera chatsopano kuti muone ngati mankhwala akutuluka. Ngati cholembera cha syringe chayamba kale ntchito, pitani ku Gawo 3 “Kukhazikitsa Dowa”.

Sinthani chosankha cha mankhwala mpaka chizindikiritso cha mankhwalawo (vvw) pachizindikirocho chikuwonetsedwa ndi chizindikirocho.

Gwirani cholembera ndi singano m'mwamba.

Kanikizani batani loyambira ndikuligwirizitsa mpaka mlingo wotsutsa udzafika ku zero (mkuyu. H).

"0" akhale kutsogolo kwa chizindikiro. Dontho la yankho liyenera kuwoneka kumapeto kwa singano. Dontho laling'ono limatha kutsalira kumapeto kwa singano, koma silidzalowetsedwa.

Ngati dontho la yankho kumapeto kwa singano silikuwoneka, ndikofunikira kubwereza ntchito II "Kuyang'ana kulandila kwa mankhwalawo", koma osapitirira kasanu ndi kamodzi. Ngati dontho la yankho silikuwoneka, sinthani singano ndikubwereza opaleshoni. Ngati dontho la yankho la Saxenda® silinawonekere, muyenera kutaya cholembera ndi kugwiritsa ntchito yatsopano.

Chidziwitso chofunikira. Musanagwiritse ntchito cholembera chatsopano kwa nthawi yoyamba, onetsetsani kuti dontho la dontho lithe kumapeto kwa singano. Izi zimatsimikizira kulandira mankhwalawo.

Ngati dontho la yankho silikuwoneka, mankhwalawo sangaperekedwenso, ngakhale mlingo woyeserera ukusuntha. Izi zitha kuwonetsa kuti singanoyo yaboweka kapena yowonongeka. Wodwala ngati sanayang'ane mankhwalawa mankhwala asanamwe jakisoni woyamba ndi cholembera chatsopano, sangalowe muyezo womwe ukufunika ndipo zotsatira za kukonzekera kwa Saxenda ® sizingatheke.

III. Mlingo

Sinthani chosankhako cha mgawo kuti muyimbe muyeso wa wodwalayo (0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg kapena 3 mg) (mkuyu. I).

Ngati mankhwalawo sanakhazikitsidwe molondola, tembenuzirani osankhiratu mankhwalawo kutsogolo kapena kumbuyo mpaka mulingo woyenera. Mlingo waukulu kwambiri womwe ungayikidwe ndi 3 mg. Wosankha mlingo amakulolani kuti musinthe mlingo. Chidole chokhacho cha mlingo ndi chiwonetsero cha mlingo chomwe chiziwonetsa kuchuluka kwa mg wa mankhwalawa mu mlingo wosankhidwa ndi wodwalayo.

Wodwala atha kumwa mpaka 3 mg ya mankhwala pa mlingo. Ngati cholembera cha syringe chogwiritsidwa ntchito chili ndi zosakwana 3 mg, mankhwala othandizira amatha kusiya 3 asanawonekere m'bokosi.

Nthawi iliyonse yomwe chosankha cha mankhwalawa chimasinthidwa, kudina kumamveka, kumveka kwa mabatani kumadalira mbali yomwe wosankha wa mankhwalawo amatembenukira (kutsogolo, kumbuyo, kapena ngati mlingo womwe waphatikizidwa umaposa kuchuluka kwa mg wa mankhwala omwe atsalira mu cholembera). Makina awa sikuyenera kuwerengedwa.

Chidziwitso chofunikira. Pamaso jekeseni aliyense, onani kuchuluka kwa mankhwala omwe wodwalayo adafota pameta ndi chizindikiro. Osawerengetsa zokhoma za cholembera.

Mulingo woyeserera ukuonetsa kuchuluka kwa yankho lomwe latsala mu cholembera, motero silingagwiritsidwe ntchito kuyeza kuchuluka kwa mankhwalawa. Osayesa kusankha Mlingo wina kuposa Mlingo wa 0.6, 1.2, 1.8, 2.4 kapena 3 mg.

Manambala omwe ali pawindo lotsogolera ayenera kukhala osiyana ndi chizindikiritso cha mankhwala - izi zikuwonetsetsa kuti wodwalayo amalandira mlingo woyenera wa mankhwalawo.

Mankhwala angati atsalira?

Mulingo wotsalira ukuwonetsa kuchuluka kwa mankhwalawa omwe atsalira mu cholembera (mkuyu. K).

Kuti mudziwe kuchuluka kwa mankhwalawa omwe atsala, gwiritsani ntchito mankhwala othandizira (Dine. L)

Sinthani chosankha cha mankhwalawa mpaka othandizira pa mlingo atasiya. Ngati ikuwonetsa "3", pafupifupi 3 mg ya mankhwalawa imasiyidwa mu cholembera. Ngati mankhwalawo a mankhwalawa akuwonetsa kuchepera kwa "3", ndiye kuti izi zikutanthauza kuti palibe mankhwala okwanira omwe ali mgulu lodzilowetsa kukhazikika kwa 3 mg.

Ngati mukufunikira kuti mupeze mankhwala ochuluka kuposa omwe asiyidwa mu cholembera

Pokhapokha ngati wodwalayo adaphunzitsidwa ndi dokotala kapena namwino, ndiye kuti amatha kugawanitsa mlingo wa mankhwalawo pakati pa zolembera ziwirizi. Gwiritsani ntchito Calculator kuti mupeze Mlingo wanu monga momwe dokotala kapena nesi anamupangira.

Chidziwitso chofunikira. Muyenera kusamala kwambiri kuti muwerenge mlingo wake molondola. Ngati mukutsimikiza kuti mugawa mankhwalawo molondola pogwiritsa ntchito zolembera ziwiri, muyenera kukhazikitsa ndi kugwiritsira ntchito mlingo wonse pogwiritsa ntchito cholembera chatsopano.

IV. Kupereka mankhwala

Ikani singano pansi pa khungu pogwiritsa ntchito jakisoni wololedwa ndi dokotala kapena namwino (mkuyu. M).

Onetsetsani kuti otsatsa mlingo ali mgawo la wodwalayo Osakhudza chida cha mankhwalawo ndi zala zanu - izi zitha kusokoneza jakisoni.

Kanikizani batani loyambira njira yonse ndikuyigwira mpaka tsamba lotsutsa likusonyeza "0" (mkuyu. N).

"0" iyenera kukhala yosiyana kwenikweni ndi chizindikiro. Potere, wodwalayo amamva kapena kumva kudina.

Gwirani singano pansi pakhungu pambuyo poti mlingo wa mankhwalawo wabwerera zero, ndipo pang'onopang'ono mulembe mpaka 6 (mkuyu. O).

Wodwala akachotsa singano pansi pa khungu m'mbuyomu, awona momwe mankhwalawo amachokera mu singano. Pankhaniyi, mlingo wosakwanira wa mankhwalawa udzaperekedwa.

Chotsani singano pansi pa khungu (mkuyu. P).

Ngati magazi abwera pamalo a jakisoni, kanikizani kaye pang'ono thonje la thonje kumalowo. Musamasewetse malo a jakisoni.

Jakisoni itatha, mutha kuwona dontho la yankho kumapeto kwa singano. Izi ndizabwinobwino ndipo sizikhudza mlingo wa mankhwala omwe waperekedwa.

Chidziwitso chofunikira. Nthawi zonse muzifufuzira zotsimikizira kuti mudziwe kuchuluka kwa Saxenda ®.

Gwirani batani loyambira mpaka tsamba lothandizira lipange "0".

Momwe mungazindikire kufalikira kapena kuwonongeka kwa singano?

Ngati, patapita nthawi yayitali pakanthawi koyamba, "0" siyikupezeka pa kontrakitala wa mankhwala, izi zitha kutulutsa kawonongeka kapena kuwonongeka kwa singano.

Izi zikutanthauza kuti wodwalayo sanalandire mankhwalawo, ngakhale atamwa mankhwalawo atasintha mlingo woyambira momwe wodwalayo akhazikitsira.

Zoyenera kuchita ndi singano yotsekedwa?

Chotsani singano monga tafotokozera mu gawo V "Mukamaliza jekeseni" ndikubwereza masitepe onse kuyambira gawo I "Kukonzekera cholembera ndi singano yatsopano".

Onetsetsani kuti muyezo wofunikira wakonzekera wodwalayo.

Musakhudze kondomuyo pakumwa mankhwala. Izi zitha kusokoneza jakisoni.

V. Mukamaliza jakisoni

Ndi singano yakunja yopumira pamalo athyathyathya, ikani kumapeto kwa singano mu kapu osakhudza kapena singano (mkuyu. R).

Pamene singano ilowa mu kapu, ikani chophimba mosamala ndi singano (mkuyu. S). Tulutsani singano ndikuyitaya, ndikuwona njira zoyenera mosamala monga malangizo a dokotala kapena namwino.

Pambuyo pa jekeseni iliyonse ikani chophimba pa syringe cholembera kuti muteteze yankho lomwe lili momwemo kuti lisayatulidwe ndi kuwala (mkuyu. T).

Ndikofunikira nthawi zonse kutaya singano pambuyo pobayira jekeseni aliyense kuti mutsimikizire jakisoni wabwino ndi kupewa kufalikira kwa singano. Ngati singano yatsekedwa, wodwalayo sangathe kupereka mankhwalawo.

Chotsani cholembera chopanda kanthu ndi singano yolumikizidwa, mogwirizana ndi malingaliro omwe dokotala wanu, namwino, wopanga mankhwala kapena malinga ndi zofuna zakomweko.

Chidziwitso chofunikira. Kuti mupewe misala yovulala mwangozi, musayese kubwezeretsanso singano yamkati pa singano. Nthawi zonse chotsani singano ku cholembera pambuyo pa jekeseni iliyonse. Izi zimathandiza kupewa kubowola singano, matenda, matenda, kutayikira kwa yankho ndikukhazikitsa mlingo woyenera wa mankhwalawa.

Sungani cholembera ndi singano kuti aliyense angafikire, makamaka ana.

Osasunthanso cholembera chanu cha syringe ndi mankhwalawo ndi singano kwa iwo.

Osamalira ayenera kugwiritsa ntchito singano zogwiritsidwa ntchito mosamala kwambiri kuti apewe kubayidwa mwangozi komanso matenda oyambukira.

Chisamaliro cha cholembera

Osasiya cholembera m'galimoto kapena malo ena aliwonse pomwe angayikidwe ndi kutentha kwambiri kapena kutentha kwambiri.

Musagwiritse ntchito Saksenda ® ngati yazizira. Potere, zomwe zikuyembekezeredwa ndikugwiritsa ntchito mankhwalawa sizingatheke.

Tetezani cholembera ku fumbi, litsiro ndi mitundu yonse ya zakumwa.

Osasamba cholembera, osamiza m'madzi kapena kumuthira mafuta. Ngati ndi kotheka, cholembera cha syringe chimatha kutsukidwa ndi nsalu yonyowa pokonza yotsekemera ndi chowonjezera chofewa.

Osaponya kapena kugunda cholembera pamalo olimba.

Wodwalayo akaponya cholembera kapena amakayikira kuti singathe kugwira ntchito, muyenera kumangirira singano yatsopano ndikuyang'ana kuchuluka kwa mankhwalawa musanapange jakisoni.

Kudzazitsa cholembera sichiloledwa. Chingwe chopanda kanthu nthawi yomweyo.

Osayesa kukonzanso inunuyo yanu kapena kupatula.

Mfundo yogwira ntchito

GLP-1 ndi kayendetsedwe ka thupi ka kudya ndi kudya. Analogue yake yopanga liraglutide yaphunziridwa mobwerezabwereza mwa nyama, pomwe zotsatira zake pa hypothalamus zidawululidwa. Mmenemo mumakhala momwe zinthu zimathandizira kuzindikiritsa kwamphamvu komanso kufooka kwa chizindikiro cha njala. Pankhani ya kuchepetsa thupi, liraglutide, motero, yankho la Saxenda limagwira makamaka pochepetsa minyewa ya adipose, yomwe imatheka chifukwa chakuchepetsa kuchuluka kwa chakudya chomwe chimadyedwa.

Popeza thupi silingathe kusiyanitsa pakati pama mahomoni achilengedwe ndi owumba, kuchepa kwa chilakolako chokwanira ndi kubereka kwa chimbudzi mukamagwiritsa ntchito Saxenda kumakhala kotsimikizika.

Mosiyana ndi zakudya zomwe zimaperekedwa pazakudya zomwe nthawi zina sizikudziwika kwa munthu ndi sayansi, mankhwala omwe ali ndi liraglutide atsimikizira kugwiridwira ntchito kokwanira pazokhudza kuchepa kwa thupi:

• sinthanso shuga
• bweretsani magwiridwe antchito a kapamba,
• thandizani thupi kuti limbe msanga, kwinaku mukumwa chakudya chokwanira kuchokera ku chakudya.

Kuchita bwino kwa Saxenda kumatsimikiziridwa ndi ziwerengero: pafupifupi 80% ya ogwiritsa ntchito omwe amayang'ana kwambiri kuchepa thupi amachepetsa thupi akamagwiritsa ntchito. Ndipo komabe, mankhwalawo pawokha sagwira ntchito monga momwe tikanakondera. Akatswiri amalimbikitsa kuti muchepetse kunenepa kuti muwonjezere mankhwala othandizira olimbitsa thupi komanso kudya zakudya zochepa zopatsa mphamvu. Chifukwa cha kugwiritsa ntchito Saxenda, kuletsa zakudya kumakhala kopweteka, komwe kumapangitsa kuchepetsa thupi kukhala njira yomwe sikukhumudwitsa dongosolo lamanjenje.

Thandizo Asanalowe mumsika wamankhwala, mankhwalawo adadutsa mayesero angapo azachipatala. Mu maphunziro atatu mwa anayi, gulu loyang'anira lidagwiritsa ntchito mankhwalawa kwa masabata a 56, lina - kupitirira miyezi iwiri. Onse omwe akuyeserera anali ndi vuto limodzi - onenepa kwambiri.Zina mwa maphunziro omwe amagwiritsa ntchito Saxenda adachita bwino kwambiri pakuchepetsa thupi kuposa odwala omwe adatenga placebo. Kuphatikiza pa kuchepa thupi, asayansi adawona kusintha kwa glucose wamagazi ndi cholesterol, komanso kukhazikika kwa zovuta.

Ubwino ndi zoyipa

Ngakhale kuti Saksenda adziwonetsa yekha kuchokera kumbali yabwino, mankhwalawa amafunika kukhala ndi udindo. Musanayambe kuchepetsa thupi ndi mankhwala, ndibwino kulemera zabwino ndi zowawa.

Ubwino wogwiritsa ntchito mankhwala omwe ali ndi liraglutide ndi awa:

• magwiridwe antchito asayansi (ena amatha kutaya makilogalamu 30 pamwezi)
• kusapezeka kwa zinthu zosadziwika mu kapangidwe kake,
• kuthekera kochotsa matenda okhudzana ndi kuchuluka kwa thupi.

Zoyipazi zimayimiriridwa ndi mndandanda wotsatira:

• mtengo wokwera wa mankhwala
• zovuta zoyipa
• mndandanda wochititsa chidwi wa zotsutsana
• kusowa kwa ntchito ya "kungokhala" kuwonda.

Malamulo ndi mlingo

• Njira yothetsera liraglutide imayendetsedwa kamodzi kamodzi patsiku, phewa kapena pamimba, makamaka nthawi yomweyo. Intramuscular kapena intravenous management ndi oletsedwa! Kutentha kwa yankho panthawi yogwiritsa ntchito kuyenera kukhala kutentha kwa chipinda.
• Njira yoyenera yogwiritsira ntchito imaphatikizira kugwiritsa ntchito 0.6 mg ya yankho tsiku limodzi sabata yoyamba. Pambuyo pake, mlingo umakulitsidwa ndi 0.6 mg sabata iliyonse. Mlingo umodzi wambiri ndi 3 mg, womwe ndi syringe imodzi ya Saxenda.
• Kutalika kwa maphunziro a kunenepa kuyenera kukhazikitsidwa payekhapayekha. Ndikofunika kuonedwa ndi dokotala amene asankha kupitiliza kugwiritsa ntchito mankhwalawa kapena kusiya maphunzirowo ngati zotsatira zofunika zithe. Kutalika kochepa kwa maphunzirowa ndi miyezi 4, kutalika kwake ndi chaka chimodzi.

Zofunika! Mankhwala ndi Saxenda ayenera kusiyidwa ngati, pambuyo pa milungu 12 ya mankhwala pakadwala 3 mg pa tsiku, kuchepa thupi kumachepera 5% ya mtengo woyambirira.

• Wolemba liraglut>

Sungani Syringe

Popeza mankhwala osowa amaperekedwa ndi chipangizo chosangalatsa chotere, ndikofunikira kudziwa zovuta zomwe zimagwira ndi cholembera.

Gawo loyamba ndikukonzekera, lomwe lili ndi mfundo izi:

• kufunafuna moyo wa alumali, dzina lake ndi barcode,
• Kuchotsa kapu
• Kufufuza yankho lokha: liyenera kukhala lopanda maonekedwe komanso lowonekera, ngati madzi ali ndi mitambo, ndizosatheka kugwiritsa ntchito,
• Kuchotsa chomata pa singano,
• kuvala singano pa syringe (iyenera kugwira mwamphamvu)
• Kuchotsa chida chakunja,
• Kuchotsa chophimba chamkati
• Kufufuza mayankho ake: mutagwira syringe mwachinsinsi, dinani batani loyambira, dontho lamadzimadzi liyenera kuwoneka kumapeto kwa singano, ngati dontho silikuwoneka, dinikizani, ngati palibe chochita, syringe iyenera kutayidwa nthawi yachiwiri, chifukwa imawonedwa ngati yosatheka.

Ndi zoletsedwa kupereka jakisoni ngati singano ikupindika kapena yowonongeka. Ma singano amatha kutayidwa, choncho ayenera kugwiritsidwa ntchito mwatsopano. Kupanda kutero, matenda a pakhungu angachitike.

Gawo lachiwiri ndikukhazikitsa mlingo wa yankho. Kuti muchite izi, sinthani chosankha kuti chikhale chizindikiro chomwe mukufuna. Pamaso pa jekeseni iliyonse, ndikofunikira kuyang'ana kuchuluka kwa yankho lomwe amatumiza ndi dispenser.

Kenako pamatsatira njira yobweretsera yankho. Pakadali pano, musakhudze chotulukacho ndi zala zanu, apo ayi, jekeseni ikhoza kusokonezedwa. Ndikwabwino kusankha malo oti jakisanani ndi adotolo, koma mulimonsemo, ndikofunikira kusintha nthawi ndi nthawi. Asanayambitse yankho, malo opaka jakisoni amayeretsedwera ndikupukuta mowa. Khungu likauma, muyenera kupanga ma penti pamalo omwe jakisoni udakonzekereratu (mutha kumasula ma crease pokhapokha kuti singano yayikiridwa). Chotsatira, muyenera kugwirizira batani loyambira mpaka wotsutsana naye athetse 0. singanoyo imachotsedwa pakhungu wodwala atakwana 6.Ngati magazi atatuluka pamalo a jakisoni, thonje la thonje liyenera kuikidwa, koma osavomerezeka konse.

Popewa zotsatira zosasangalatsa, cholembera cha syringe chiyenera kutetezedwa kufumbi ndi madzi, yesetsani kuti musaponye kapena kugunda. Kudzazitsanso chida sichingatheke - pambuyo pa kugwiritsidwa ntchito komaliza, kuyenera kutayidwa.

Zotsatira zoyipa

Popeza magawo omwe amagwiritsidwa ntchito ndi mankhwala a Saxenda amasokoneza ma hormonal ndipo amakakamiza ziwalo zambiri kuti zizigwira ntchito mosiyanasiyana, ngakhale mutatsatira kwambiri mankhwalawo, sizingatheke kupewa zovuta.

• thupi lawo siligwirizana
• arrhythmias
• kukomoka
• kutopa, kuchepa kwa ntchito, ulesi ndi kukhumudwa,
• migraines
• achina,
• kulephera kupuma ndi matenda opatsirana thirakiti,
• kuchepa kwamtima
• mavuto ndi m'mimba thirakiti (pakati pawo mseru, kutulutsa, kudzimbidwa, kutsegula m'mimba, kupweteka, kupweteka, kusanza, kupweteka kwam'mimba, gastroesophageal Reflux ndizodziwika bwino).

Monga lamulo, zotsatira zoyipa zimapezeka m'milungu ingapo yoyambirira ya Saxenda. Mtsogolomo, machitidwe oterowo a thupi pakukhazikitsa liraglutide amayamba kutha. Pakangodutsa milungu inayi, vutoli limakhala labwino. Ngati zizindikiro zikulimbikira, ndibwino kukaonana ndi dokotala nthawi yomweyo.

Osatinso, koma zimachitika kuti kuchepa thupi mothandizidwa ndi Saxenda kumayambitsa kusowa kwamadzi, kapamba, cholecystitis, kuwonongeka kwaimpso.

Koti mugule

Mutha kugula ma Saksenda rr mu pharmacy network kapena mumayitanitse mu pharmacy ya pa intaneti. Mankhwala oti mugule siofunika. Mtengo wa ma CD a ma syringe-cholembera ndi ma ruble 26,200. Kugula mapaketi angapo a mankhwala nthawi imodzi kumatha kupulumutsa pang'ono.

Ma singano a syringe amathanso kugulidwa pamisika yogulitsa malondayo palokha. Mtengo wa zidutswa za 100 mm ndi pafupifupi ma ruble 750. Chiwerengero chomwecho cha singano za 6 mm chingawononge ma ruble 800.

Amagwiritsidwa ntchito kuchepetsa kuchuluka kwa chakudya chomwe mumadya, liraglutide imangopezeka ku Saxend zokha. Ndi gawo la mankhwala Victoza, opangidwa ndi kampani yomweyo. Kupanga kwakhazikitsidwa kuyambira 2009. Kutulutsa mawonekedwe - cholembera cha syringe ndi yankho la liraglutide ndi voliyumu ya 3 ml. Katemera wa makatoni amakhala ndi ma syringe awiri. Mtengo - 9500 rubles.

Ambiri amachepetsa thupi akufunsa - Victoza kapena Saxenda kuti achepetse thupi? Akatswiri amavomereza mosagwirizana njira yachiwiriyo, akuwonetsa kusiyana kwakukulu pakati pa mankhwalawa: Saksenda ndi mankhwala atsopano, motero, opita patsogolo kwambiri. Polimbana ndi kunenepa kwambiri, ndizothandiza kwambiri kuposa Victoza, yemwe, poyambirira, adapangidwa ngati njira yothandizira matenda ashuga. Kuphatikiza apo, gawo la Saxenda cholembera ndilokwanira kugwiritsidwa ntchito kochulukirapo, ndipo kuchuluka kwa zovuta ndi zotsutsana panthawi ya mankhwala kumachepetsedwa.

Mtengo wa zothetsera zochokera liraglutide sizotheka aliyense. Ambiri amachepetsa thupi amakonda chidwi cha Saxenda, chomwe chingakhale chothandiza polimbana ndi kunenepa kwambiri. Mankhwala ali okonzeka kupereka m'malo mwake omwe akuwonetsa zochizira zofananira:

1. Belvik - mapiritsi olamulira kudya omwe amayambitsa zolandila muubongo zomwe zimayambitsa satiety.
2. Baeta ndi amino acid amidopeptide yomwe imathandizira kuti madzi asamayendetse m'mimba ndipo potero amachepetsa chikhumbo. Amapezeka mu mawonekedwe a yankho lomwe limayikidwa mu cholembera.
3. Reduxin ndi mankhwala ochizira kunenepa kwambiri ndi sibutramine. Amapezeka mu kapisozi kapamwamba.
4. Orsoten ndi mankhwala osokoneza bongo mwanjira ya makapisozi kutengera orlistat. Amalemba kuti achepetse kuyamwa kwa mafuta m'mimba.
5. Lixumia ndi mankhwala othandizira kuchepetsa hypoglycemia. Imagwira ngakhale osadya. Amapezeka mu mawonekedwe a yankho lomwe limayikidwa mu cholembera.
6. Forsiga ndi mankhwala a hypoglycemic monga mapiritsi.
7. Novonorm ndi mankhwala amkamwa.Kulimbitsa thupi ndi njira yachiwiri.

Ndemanga ndi zotsatira za kuchepa thupi

Wodziwika bwino ndi Saksenda. Ndidagwiritsa ntchito yankho pazotsatira za endocrinologist (sindinathe kuchepetsa thupi kwanthawi yayitali). Anthu omwe amatcha mankhwalawo kuti "matsenga" mwina sanapezebe. M'malo mwake, jakisoni yekha samatsimikizira 100% kuwonda - muyenera kutsatira zakudya zochepa zopatsa mphamvu komanso zolimbitsa thupi. Izi ndikutanthauza kuti mukamadya makeke ndikuwatsuka ndi koloko, simuyenera kukhala ndi chiyembekezo chakuchepetsa kwambiri thupi ndi Saxenda. Koma pazonse, chidachi ndi chabwino kwambiri. Matendawa amakumba kugaya chakudya, amathandiza kusiya magawo akulu. Zomwe zimangowononga ndikupeza jakisoni. Ngati simunadzivulaze nokha, zimakhala zovuta.

Anastasia, wa zaka 32

Ndazindikira izi: atsikana omwe amafunika kutaya ma kilogalamu angapo nthawi zambiri amakhala ndi chidwi chofuna kuchepetsa mankhwala. Inde, sawona zoopsa zake. Mpaka posachedwapa, ndinalinso pakati pawo. Ndi kutalika kwa 169 masentimita, anali wolemera 65 kg ndipo amadziona ngati wonenepa. Nditawerenga ndemanga zochepetsa thupi ndi Saksenda, ndidaziyitanitsa mu pharmacy ya pa intaneti. Adayamba kubaya. Kulakalaka kunachepa patsiku lachiwiri la mankhwala. Sindinadye chilichonse, ndimangomwa tiyi ndi madzi. Kenako zinthu sizinasinthe - jakisoni utatha, thupi langa linakana. Mwachibadwa, zoyipa zake sizinatenge nthawi kudikirira: kupweteka mutu, nseru, mtundu wina wa "cottonness", misonzi ... Patatha sabata ndi theka kuyesera koteroko, ndinayenera kupita kwa adotolo. Zotsatira zake, ndinatha kuchepa thupi moyenera, koma thanzi langa linagwedezeka. Osabwerezanso cholakwa changa. Ndizowopsa kugula mankhwala oopsa popanda dokotala!

Ndakhala ndikugwiritsa ntchito Saksend kwa mwezi umodzi. Ndidayamba maphunzirowo chifukwa ndimayenera kuti ndichepetse shuga. Adanenanso dokotala. Sindikuwona zoyipa zilizonse zovuta. Pokhapokha madzulo chizungulire pang'ono ndipo nthawi zina chimanjenjemera. Ndidawerenga zowopsa pa intaneti: ena amakhala ndi kapamba, pomwe ena amakomoka. Modabwitsa. Saxenda adalandilidwa bwino ndi thupi langa. Ndimakhala ndimayesa pafupipafupi, kotero ngakhale m'mwezi wowerengeka shuga adatsika kuchoka pa 12 mpaka 6. Nthawi yomweyo, ndidatha kutaya makilogalamu 4. M'mbuyomu, kunali kulakalaka kwa nkhandwe, koma tsopano zonse zili m'njira yovomerezeka, zomwe ndimakondwera nazo kwambiri. Chinthu chimodzi ndikukhumudwitsa - mtengo. Phukusi limakhala lalitali bwanji? Ndizosiyana ndi aliyense, koma mulimonsemo ndi wokwera mtengo.

Ndemanga za madotolo ndi akatswiri

Maria Anatolyevna, katswiri-endocrinologist

Liraglutide ndi mankhwala othandiza kunenepa kwambiri. Ntchito yake ndikuwongoletsa kapamba, yemwe amatulutsa mahomoni omwe amayambitsa kilogalamu - glucagon ndi insulin. Msika wamakono wamankhwala samapereka mankhwala ambiri ndi liraglutide, kotero omwe alipo omwe ndiofunika kwambiri. Masiku ano nthawi zambiri amagwiritsidwa ntchito osati kungowonetsa mwachindunji, komanso kuchepa thupi. Zomwe zimachitika mderali zimatheka.

Saxenda ndi mankhwala opangidwa ku Denmark. Pezani mumasitolo achi Russia ndikosavuta, mutha kugula popanda mankhwala. Koma kugwiritsa ntchito kumakhala koopsa. Ngati mukufuna kuchepetsa thupi pogwiritsa ntchito mankhwalawa, muyenera kukambirana ndi endocrinologist. Ngati dokotala akuwona kuti mankhwalawa ndi ofunikadi, apatsidwa mlingo woyenera ndi nthawi ya maphunzirowo. Pamodzi ndi kugwiritsa ntchito Saxenda, ndingapangire kuchepetsa kuchepa kwa maswiti ndi zinthu zina za ufa, kuwonjezera masewera olimbitsa thupi ndikuthana ndi zizolowezi zoyipa. Kenako zidzachitika osati kungochepetsa thupi, komanso kusintha zomwe zili wamba.

Konstantin Igorevich, dokotala wabanja

Masiku ano, ndi mafashoni kugwiritsa ntchito mankhwala pakati pa omwe akuchepetsa thupi m'malo mwa zakudya zomwe zakhala ndi nthawi yotopa.Palibe chodabwitsanso: amati kuchokera kulikonse kuti, mosiyana ndi zopatsa thanzi, mankhwala amathandizadi kuti muchepetse thupi. Ndizachisoni, "akatswiri" amaiwala za zoopsa zomwe zimachitika chifukwa chogwiritsa ntchito mankhwala mosawerengera. Makamaka, Saksenda ndi mankhwala osokoneza bongo a Victoza, omwe amapangidwira kuchiza matenda a shuga a 2. Mutha kuchepetsa kunenepa ndi chithandizo chake ngati mugwiritsa ntchito mogwirizana ndi malangizo komanso nthawi yomweyo kutsatira zakudya zopatsa thanzi. Koma mankhwala aliwonse okhala ndi liraglutide sangathe kugwiritsidwa ntchito kungotaya makilogalamu 3-5. Zokhudza thupi zimakhala zamphamvu kwambiri komanso zosasinthika, chifukwa tikulankhula za mahomoni. Zikuwoneka kuti nkhaniyi imayenera kugawidwa pakati pa odwala ndi madokotala omwe. Ndipo ngati mukukonzekera kutenga mwayi, tengani chidwi ndi mndandanda wa zotsutsana ndikuphunzira mosamala mlingo woyenera.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa adapangidwa kuti azigwiritsa ntchito poyambira. Amaperekedwa ngati yankho la jakisoni. Mankhwalawa ndi amodzi. Izi zikutanthauza kuti kapangidwe kameneka ndikuphatikiza 1 yogwira - liraglutide. Kuphatikizika kwake mu 1 ml ya mankhwalawa ndi 6 mg. Mankhwalawa amapangidwa mu syringes yapadera. Kukula kulikonse ndi 3 ml. Chiwerengero chogwira ntchito mu syringe ndi 18 mg.

Kuphatikizikako kumaphatikizanso zinthu zomwe sizimakhudza kuchepa thupi:

• phenol
• sodium hydrogen phosphate dihydrate,
• propylene glycol
• hydrochloric acid / sodium hydroxide,
• madzi a jakisoni.

Mankhwalawa amaperekedwa phukusi lomwe lili ndi ma syringes asanu.

Mankhwalawa adapangidwa kuti azigwiritsa ntchito poyambira.

Momwe mungatenge Saxenda

Saxenda imapezeka mu mawonekedwe a yankho la subcutaneous (osati intramuscular!) Jekeseni. Ndikofunikira kuchita jakisoni 1 patsiku, nthawi iliyonse yabwino. Ngakhale chakudyacho.

Jakisoni amachitidwa pamimba, ntchafu kapena phewa. Pachifukwa ichi, singano zotayika zimagwiritsidwa ntchito, zomwe zimayikidwa pabotolo ndi mankhwala.

Pansipa mutha kuwona kanema wokhala ndi malangizo atsatanetsatane amomwe mungatenge Saxenda:

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amaperekedwa kwa odwala omwe ali ndi matenda osokoneza bongo a shuga kuti awongolere. Saxendum imalembedwa kwa odwala onenepa kwambiri.

Mankhwalawa akuphatikiza pazakudya zoyenera, potengera kuchepetsa ma calories, komanso kuwonjezera zolimbitsa thupi. Amagwiritsidwa ntchito kwanthawi yayitali mpaka pali zotsatira zabwino.

Wothandizidwa ndi hypoglycemic amaperekedwa kwa odwala okhala ndi cholozera chachikulu cha thupi pamtunda wama 27.

Ndi chisamaliro

Pali matenda angapo omwe ndi bwino osagwiritsa ntchito Saxenda. Komabe, palibe malamulo okhwima ogwiritsira ntchito mankhwalawa. Zotsutsana:

• maphunziro a kulephera kwa mtima I-II,
• ukalamba (woposa zaka 75),
• matenda a chithokomiro
• chizolowezi chokhala ndi kapamba.

Momwe mungatenge Saxenda

Mankhwalawa sagwiritsidwa ntchito kudzera m'mitsempha kapena m'mitsempha. Kuwongolera mozungulira kumachitika kamodzi patsiku. Nthawi yophera jakisoni imakhala iliyonse, ndipo palibe kudalira chakudya.

Madera olimbikitsidwa am'thupi momwe mankhwalawa amathandizira bwino: phewa, ntchafu, pamimba.

Yambani maphunziro a mankhwala ndi 0,6 mg wa yogwira ntchito. Pambuyo masiku 7, kuchuluka kumachulukanso ndi 0,6 mg. Kenako, mlingo umapangidwanso sabata iliyonse. Nthawi iliyonse, 0,6 mg ya liraglutide iyenera kuwonjezeredwa. Kuchuluka kwa tsiku lililonse kwa mankhwalawa ndi 3 mg. Ngati, ngati atagwiritsidwa ntchito nthawi yayitali, adazindikira kuti kulemera kwamthupi kumatsika osaposa 5% ya kulemera konse kwa wodwalayo, maphunzirowa adasokonezedwa kuti asankhe analogue kapena kubwezeretsanso mlingo.

Kumwa mankhwala a shuga

Regimen yodziwika bwino yamankhwala imagwiritsidwa ntchito, nthawi zina. Popewa hypoglycemia, tikulimbikitsidwa kuti muchepetse insulin yambiri.

Kuti mupewe hypoglycemia, tikulimbikitsidwa kuti muchepetse insulin yambiri.

Kukonzekera cholembera ndi singano kuti mugwiritse ntchito

Zolowera zimachitika m'magawo:

• Chotsani chimbudzi ku syringe,
• singano yotayika imatsegulidwa (chomata chimachotsedwa), kenako chitha kuyikika pa syringe,
• musanagwiritse ntchito, chotsani kapu yakunja ndi singano, yomwe pambuyo pake imakhala yothandiza, kuti musayitaye,
• ndiye chophimba chamkati chimachotsedwa, sichidzafunika.

Nthawi iliyonse mankhwalawa akagwiritsidwa ntchito, ma singano othandizira amagwiritsidwa ntchito.

Matumbo

Kusintha pakati pa mseru, chimbudzi, kapena kudzimbidwa. Kupukusa kumasokonekera, kuwuma pamkamwa kumakulirakulira. Nthawi zina pamakhala kuyenda kwamkati mwa m'mimba, kumeza, kupangidwa kwa mpweya kumakulirakulira, kupweteka kumachitika pamimba. Pancreatitis nthawi zina amakula.

Zotsatira zoyipa za mankhwalawa zimatha kusanza motsutsana ndi maziko amphuno.

Zolemba ntchito

Odwala opitirira zaka 65 amaloledwa kugwiritsa ntchito mankhwalawa kukonza zolemetsa. Njira yakugwiritsira ntchito ndi yofanana. Nthawi zambiri, kusintha kwa mlingo sikofunikira.

Odwala omwe ali ndi matenda ashuga opitirira zaka 75 sayesedwa mankhwala; Izi zimagwiranso ntchito kwa odwala matenda a shuga omwe adapezeka kuti ali ndi "vuto la impso" kapena "chiwindi cholakwika."

Timapereka kuchotsera kwa owerenga tsamba lathu!

Muubwana, mankhwalawa sanalembedwe, chifukwa palibe chidziwitso chokhudza chitetezo chake ndi kugwira ntchito kwa mwana wosakwana zaka 18.

Kwa amayi omwe akuyamwitsa, mankhwalawa amatsutsana.

Saksenda kapena Viktoza - zomwe zili bwino

Pokonzekera zonsezi, chinthu chimodzi chogwira ntchito chilipo. Liraglutide amathandiza kuchepetsa kuchuluka kwa zakudya zomwe zimadyedwa, izi zimaperekedwa ndi mankhwala a Saksenda. Mankhwala amapangidwa mwanjira yomweyo yotulutsidwa, koma ku Viktoz, mlingo wa gawo lomwe limagwira ndiwofunikira kwambiri.

Kuphatikiza apo, izi sizimagwiritsidwa ntchito motsutsana kunenepa kwambiri komanso kunenepa kwambiri, koma kukonza mkhalidwe wachiwiri wa matenda ashuga. Saxenda sagwiritsidwa ntchito pochiza matenda a endocrine.

Ndiye kuti, mankhwala aliwonse ndi abwino pagawo lawo logwiritsira ntchito. Sangafanane, chifukwa amagwiritsidwa ntchito pazolinga zosiyanasiyana. Saksenda - amachepetsa thupi ndipo samamulola kuti abwerere, Viktoza - amathandizira odwala matenda ashuga komanso samakhudza thupi.

Pa mbali ya chiwindi ndi biliary thirakiti

Mapangidwe a calculi. Pali kusintha kwa zizindikiro zamankhwala posanthula chiwindi.

Mwa mawonetsedwe ake omwe alipo, nthawi zambiri, chitukuko cha urticaria, anaphylactic mantha chimadziwika. Kutheka kwa mawonekedwe omaliza a zizindikirozo kumachitika chifukwa cha zinthu zingapo zam'machitidwe: hypotension, arrhythmia, kupuma movutikira, chizolowezi cha edema.

Mwa mawonekedwe omwe alipo a ziwengo pakumwa mankhwalawa nthawi zambiri, chitukuko cha urticaria chimadziwika.

Gulu la mankhwala

• Hypoglycemic wothandizira - glucagon-ngati receptor polypeptide antagonist

Gwiritsani ntchito mu ukalamba

Pa mankhwala, kukula kwa zoyipa, kusokonezeka kwa thupi sizichitika. Chifukwa chake, zaka sizikhudza pharmacodynamics ya mankhwala. Pazifukwa izi, kuyambiranso kwa mlingo sikuchitika.

Kugwiritsa ntchito mu ukalamba ndikotheka, chifukwa nthawi ya mankhwalawa palibe chitukuko chosagwirizana, kusokonezeka kwa thupi.

Kuyenderana ndi mowa

Sizoletsedwa kuphatikiza zakumwa zokhala ndi zakumwa zoledzeretsa ndi mankhwalawo. Izi zikuchitika chifukwa cha kuwonjezeka kwa katundu pa chiwindi, komwe kungathandize kuchepetsa kuyamwa kwa shuga.

Sizoletsedwa kuphatikiza zakumwa zokhala ndi zakumwa zoledzeretsa ndi mankhwalawo.

M'malo mwa mankhwala omwe mukufunsidwa, njira zoterezi zimagwiritsidwa ntchito:

Zosungidwa zamankhwala

Syringe yomwe sinatsegulidwe isungidwe mufiriji kutentha kwa +2. + 8 ° C. N`zosatheka kuzimitsa mankhwala. Pambuyo pakutsegula, syringe imatha kusungidwa kutentha mpaka + 30 ° C kapena mufiriji. Iyenera kutsekedwa ndi chipewa chakunja. Ana sayenera kulandira mankhwalawo.