Mlingo wa Januvia - mapiritsi okhala ndi mafilimu: biconvex, ozungulira, pamtunda wa 25 mg - kuwala pinki ndi kuwala kwamtengo wamtengo wapatali ndi zolemba "221", pamlingo wa 50 mg - beige, wopepuka wa 100 mg - beige, yolembedwa "277" (ma PC 14. m'matumba, pamatabwa a 1, 2, 4, 6 kapena 7 matuza).

Mapangidwe piritsi limodzi:

• yogwira ntchito: sitagliptin phosphate hydrate - 32.13 / 64.25 / 128.5 mg (womwe ndi wofanana ndi zomwe zili ndi sitagliptin - 25/50/100 mg),
• othandizira: microcrystalline cellulose, calcium hydrogen phosphate yosagundika, croscarmellose sodium, magnesium stearate, sodium stearyl fumarate,
• kuphatikiza mafilimu: pa mlingo wa 25 mg - Opadrai II Pink 85 F 97191, pa mlingo wa 50 mg - Opadrai II Kuwala beige 85 F 17498, pamlingo wa 100 mg - Opadrai II Beige 85 F 17438 (polyvinyl mowa, titanium dioxide, polyethylene glycol 3350, talc, iron oxide chikasu, iron oxide ofiira).

Mankhwala

Mbali yogwira ya Januvia is sitagliptin, inhibitor yosankha kwambiri ya enzyme DPP-4 (dipeptidyl peptidase-4), yopangidwira chithandizo cha matenda a shuga 2 a mellitus. Pankhani ya kapangidwe ka mankhwala ndi zochita za pharmacological, sitagliptin amasiyana ndi GLP-1 analogues (glucagon-ngati peptide-1), zotumphukira za sulfonylurea, insulini, biguanides, γ-receptor agonists (woyambitsa ndi peroxisome proliferator - PPAR-γ), α-glycosidase amylin. Sitagliptin, kuletsa DPP-4, potero imakulitsa kuchuluka kwa GLP-1 ndi HIP (glucose-insulinotropic peptide) - mahomoni awiri odziwika omwe ali mbali ya banja la incretin, omwe amatulutsidwa m'matumbo kwa maola 24, ndipo msinkhu wake umachulukana poyankha pakudya. Ma incretins ndi gawo limodzi la masanjidwe amkati a thupi pakuwongolera glucose homeostasis, amathandizira kuphatikizika kwa insulin ndi katulutsidwe kake ka pancreatic β-cell chifukwa chakuwonetsa ma intracellular ma processor omwe amaphatikizidwa ndi cyclic AMP (adenosine monophosphate), yokhala ndi glucose yabwinobwino kapena yowonjezera.

GLP-1 imalepheretsa kubisalira kwa glucagon ndi cy-cell ya kapamba. Kutsika kwamisempha ya glucagon poyambira kumbuyo kwa kuchuluka kwa insulin kumalepheretsa kupanga kwa chiwindi ndi chiwindi, zomwe zimapangitsa kutsika kwa glycemia.

Pankhani ya shuga wamagazi ochepa, momwe ma insretins amapangira insulin ndi secretion wa glucagon samawonedwa, sizikhudza kutulutsidwa kwa glucagon poyankha hypoglycemia. Mu vivo, puloteni ya DPP-4 imachepetsa kugwira ntchito kwa ma insretin, mwachangu kuwawongolera ndi kuwapangitsa kukhala magawo osagwira ntchito.

Sitagliptin, yolepheretsa kugwira ntchito kwa DPP-4, motero imalepheretsa ma hydrolysis a ma insretin, kukulitsa kuchuluka kwa plasma ya mitundu yogwira ntchito ya GLP-1 ndi HIP, yomwe imakulitsa kutulutsidwa kwa insulini ndikuthandizira kuchepetsa kutulutsa shuga. Mtundu wachiwiri wa matenda ashuga a shuga ndi hyperglycemia, kukonza kotereku kwa insulin ndi glucagon kumapangitsa kuchepa kwa ndende ya HbA1c (glycosylated hemoglobin) ndi kuchepa kwamlingo wa glucose wotsimikizika pamimba yopanda kanthu komanso pambuyo poyesa kupanikizika.

Kutenga muyezo umodzi wa Januvia wokhala ndi matenda ashuga a 2 kumabweretsa kuyimitsidwa kwa DPP-4 enzyme kwa maola 24, zomwe zimapangitsa kuti kuchuluka kwa ma protein omwe amayenda mozungulira GLP-1 ndi HIP kumawonjezeka nthawi ziwiri mpaka zitatu, kuchuluka kwa insulin ndi C-peptide kumawonjezeka, ndikuchepa kuchuluka kwa plasma glucagon, kudya mwachangu glycemia ndipo pambuyo poti katundu wambiri kapena glucose athetse.

Pharmacokinetics

Malamulo a kinetic a kayendedwe ka mankhwala ndi kwachilengedwe komwe kumachitika ndi sitagliptin m'thupi la anthu athanzi komanso odwala omwe ali ndi matenda a shuga 2 aphunziridwa kwathunthu. Makhalidwe a odzipereka athanzi pambuyo pakukonzekera kwapakamwa kwa 100 mg ya sitagliptin: mayamwidwe - mwachangu, mtengo wa TC_max (nthawi yofika pozindikira kwambiri - - maola 4 - 4 kuyambira nthawi ya makonzedwe, AUC (dera lomwe ili pansi pa "nthawi yokhazikika") - 8.52 μmol / ola, chizindikiro ichi chikufanana ndi mlingo womwe watenga, C_max - 950 nmol / L, T_1/2 (pafupifupi theka la moyo) - maola 12.4 AUC ya sitagliptin itatha kumwa kwa 100 mg ya mankhwalawa itatha kuchuluka kwa boma pambuyo pa kumwa koyamba mlingo wowonjezereka

14% Kusintha kwa intra- ndi intersubject mu AUC sikungatheke.

Makhalidwe a Pharmacokinetic a Januvia:

mayamwidwe: chizindikiro cha bioavailability mtheradi wa sitagliptin ndi

87%, kuphatikiza pamodzi mankhwala omwe ali ndi mafuta osakhudzana ndi zakudya sizimakhudza ma pharmacokinetics, kufalitsa: pambuyo pa mlingo umodzi wa mankhwalawa mu 100 mg, pafupifupi kuchuluka kwa magawidwe a sitagliptin m'njira zofanana m'mawu athanzi

198 l. Gawo lomangira mapuloteni a plasma ndilochepa kwambiri (

38%), kagayidwe: mpaka 79% ya sitagliptin imachotsedwa impso sizinasinthidwe, gawo laling'ono lokha lomwe limalowetsedwa limapukusidwa pambuyo 14 C-yolembedwa kuti sitagliptin

16% ya radioactive mankhwala atachotsedwa mu mawonekedwe a metabolites, ma metabolites 6 a sitagliptin adapezeka ndikutsatira, ambiri osakhala ndi DPP-4 inhibitory effect, excretion: pambuyo pa 14 C-yolemba kuti sitagliptin idaperekedwa pamutu wathanzi, mpaka 100% ya mankhwala idachotsedwa mu sabata limodzi kuyambira mphindi yoyendetsera motere: kudzera m'matumbo - 13%, impso - 87%. T_1/2 Pamene kumwa pakamwa 100 mg

12,4 h, chilolezo cha impso

Zizindikiro zogwiritsidwa ntchito

• monotherapy: Odwala omwe amatsata zakudya zapadera ndikuchita zolimbitsa thupi amadziwika kuti ndi mankhwala omwe amakongoletsa kuwongolera kwamatenda a mtundu wa 2,
• mankhwala ophatikiza: kuphatikiza ndi metformin kapena PPARγ receptor agonists (thiazolidinediones) amalembera odwala omwe ali ndi mtundu wa 2 matenda a shuga kuti athandizire kuwongolera glycemic, ngati vuto la kudya ndi zochitika zolimbitsa thupi zimaphatikizidwa ndi monotherapy.

Contraindication

• mtundu 1 shuga
• matenda ashuga ketoacidosis,
• Nthawi yokhala ndi pakati komanso mkaka oyamwa,
• ana ndi achinyamata osakwana zaka 18,
• Hypersensitivity ku zilizonse za mankhwala.

Zotsatira zoyipa: Januvia ayenera kumwedwa mosamala pakulephera kwa impso. Odwala omwe ali ndi zolimbitsa kwambiri komanso aimpso kulephera ndi aimpso mu terminal gawo omwe amafuna hemodialysis amafuna kusintha kwa sitagliptin.

Malangizo ogwiritsira ntchito Januvia: njira ndi mlingo

Mapiritsi a Januvia amatengedwa pakamwa, ngakhale chakudyacho.

Mlingo woyenera wa monotherapy, komanso wophatikiza ndi metformin kapena agonist wa PPARγ (thiazolidinediones), 100 mg kamodzi patsiku.

Ngati wodwalayo adayiwala kumwa mapiritsi ena, ayenera kumwedwa mwachangu, atakumbukira za kudumpha mlingo, koma osalola kulandira mapiritsi awiri.

Zotsatira zoyipa

Januvia ngati monotherapy komanso kuphatikiza mankhwala ena a hypoglycemic nthawi zambiri amaloledwa. Zomwe zimachitika pazochitika zoyipa, komanso pafupipafupi kudzipatula kwa sitagliptin chifukwa cha zotsatira zosayenerera, malinga ndi kafukufuku wazachipatala, zinali zofanana ndi zomwe zinajambulidwa chifukwa chodzatenga placebo.

Zochitika zosagwirizana popanda kugwiritsa ntchito sitagliptin muyezo wa tsiku ndi tsiku wa 100 ndi 200 mg, koma ndizofala kuposa mwa odwala omwe analandira placebo (≥ 3% ya milandu): matenda amtundu wa kupuma kwam'mimba, nasopharyngitis, mutu, matenda am'mimba, arthralgia.

Zotsatira zina zoyipa ku Januvia:

• GI thirakiti (m'mimba): kupweteka kwam'mimba, nseru, kusanza, kutsekula m'mimba,
• kuchuluka kwa ma labotale (osawerengeka kukhala kofunika kwambiri): kuchuluka pang'ono kwa uric acid (palibe gout yomwe idalembedwa), kuchepa pang'ono kwa kuchuluka kwa zamchere phosphatase, pang'ono komwe kumalumikizidwa ndi kuchepa kochepa kwa gawo lachifupa la alkaline phosphatase, kuchuluka pang'ono kwa leukocytes chifukwa cha kuchuluka kwa neutrophils (chodabwitsa wolemba m'maphunziro ambiri, koma osati onse.
• dongosolo lamtima: kusintha kwakukuru m'mawu ofunikira ndi ma electrocardiograms (ECG), kuphatikizapo nthawi ya QTc, sikunawonedwe.

Bongo

Kafukufuku wachipatala ndi odzipereka wathanzi awonetsa kuti sitagliptin mu gawo limodzi la 800 mg nthawi zambiri amaloledwa. Munthawi imodzi, kusintha kwakuchepa koperewera pakumveka kwa QTc kudadziwika. Kudya kwa tsiku ndi tsiku kopitilira 800 mg mwa anthu sikunaphunzire.

Pankhani ya mankhwala osokoneza bongo, tikulimbikitsidwa kuti njira zothandizira zofunikira ziyenera kumwedwa: kuchotsa zatsalira zosapsa zam'mimba mundawo, kuyang'anira pafupipafupi zizindikiro zofunika, kuphatikizapo ECG, komanso kuperekedwa kwa chithandizo chamankhwala ngati kuli koyenera.

Mankhwalawa samalephera kuyenda bwino (kwa maola atatu a hemodialysis), malinga ndi kuzipenda zamankhwala, ndi 13.5% yokha ya mankhwalawa omwe amachotsedwa m'thupi). Ndi chosowa chachipatala, dialysis ya nthawi yayitali imatha kutumikiridwa. Palibe data pakadali pano yochotsa sitagliptin pa peritoneal dialysis.

Malangizo apadera

Malinga ndi kafukufuku wazachipatala, chifukwa chotenga Januvia ngati mankhwala a monotherapy kapena ngati gawo la chithandizo chovuta ndi metformin / pioglitazone, hypoglycemia imayamba mu odwala omwe ali ndi pafupipafupi ofanana ndi a placebo.

Kugwiritsa ntchito kwa mankhwalawa kuphatikiza ndi mankhwala omwe angayambitse hypoglycemia, mwachitsanzo, ndi insulin kapena zotumphukira za sulfonylurea, sizinaphunzire.

Mimba komanso kuyamwa

Chifukwa cha kusowa kwa deta kuchokera kumayendedwe olamulidwa pamayendedwe otetezeka ndikuyenda bwino kwa mankhwalawa kwa amayi apakati, Januvius, monga othandizira ena a hypoglycemic pazoyang'anira pakamwa, osavomerezeka kuti agwiritsidwe ntchito panthawi yapakati.

Palibe data pakumasulidwa kwa sitagliptin pa mkaka wa m`mawere, kotero mankhwalawa sanalembedwe panthawi yoyamwitsa.

Mu vuto laimpso

Odwala omwe ali ndi vuto la impso amafunikira kusintha kwa Januvia, komwe tikulimbikitsidwa kuti kuwunika kwa impso kuchitike isanayambike maphunziro ndikubwereza mobwerezabwereza pamankhwala.

Kusintha kwa malingana ndi kuchuluka kwa kulephera kwa aimpso ndi chilolezo cha creatinine (QC):

• kulephera kwapakati, CC> 50 ml / min (kuchuluka kwa ma serum creatinine: mwa amuna - osakwana 1.7 mg / dl, mwa akazi - osakwana 1.5 mg / dl): kusintha kwa mlingo sikofunikira,
• kulephera kwaimpso, CC kuyambira 30 mpaka 50 ml / mphindi (seramu creatinine ndende: mwa amuna - 1,7-3 mg / dl, mwa akazi - 1.5-2.5 mg / dl): tsiku ndi tsiku - 50 mg mu 1 mlingo
• kulephera kwambiri kwa aimpso, QC

Maphunziro: Yoyamba University State Medical University yotchedwa I.M. Sechenov, wapadera "General Medicine".

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo aboma. Kudzipatsa nokha mankhwala kuopsa!

Asayansi ochokera ku Yunivesite ya Oxford adachita maphunziro angapo, pomwe adazindikira kuti zamasamba zimatha kukhala zovulaza ku ubongo wa munthu, chifukwa zimapangitsa kuchepa kwa unyinji wake. Chifukwa chake, asayansi amalimbikitsa kuti asachotsere konse nsomba ndi nyama muzakudya zawo.

Ngati mungagwere kuchokera pabulu, mukulola khosi lanu kusiyana ndi kugwa kuchokera pa kavalo. Ingoyesani kutsutsa mawu awa.

Pali ma syndromes osangalatsa kwambiri azachipatala, monga kuphatikiza zinthu. M'mimba mwa wodwala m'modzi wodwala mania uyu, zinthu 2500 zakunja zidapezeka.

Mwazi wa munthu "umayenda" m'matumbo omwe akukakamizidwa kwambiri, ndipo ngati umphumphu wake waphwanyidwa, amatha kuwombera mpaka 10 metres.

Kutentha kwambiri kwa thupi kudalembedwa ku Willie Jones (USA), yemwe adamulowetsa kuchipatala ndi kutentha kwa 46,5 ° C.

Okonda akapsopsona, aliyense wa iwo amataya 6.4 kcal pamphindi, koma nthawi yomweyo amasinthana mitundu pafupifupi 300 ya mabakiteriya osiyanasiyana.

Vibrator woyamba adapangidwa m'zaka za zana la 19. Adagwira ntchito pa injini yankhonya ndipo adapangira kuti azitsatira khungu la akazi.

Poyesera kuti wodwalayo atuluke, madokotala nthawi zambiri amapita kutali kwambiri. Ndiye, mwachitsanzo, Charles Jensen wina mzaka kuyambira 1954 mpaka 1994. adapulumuka ntchito zopitilira 900 neoplasm.

Munthu aliyense samangokhala ndi zala zapadera, komanso chilankhulo.

Mafupa aanthu ndi olimba kwambiri kuposa konkriti.

Anthu omwe amakonda kudya chakudya cham'mawa nthawi zambiri amakhala onenepa kwambiri.

Ku UK, kuli lamulo malinga ndi momwe dokotala wothandizira amatha kukanachita opaleshoni ngati atasuta kapena wonenepa kwambiri. Munthu ayenera kusiya zizolowezi zoipa, kenako, mwina, sangafunikire opareshoni.

Caries ndimatenda ofala kwambiri padziko lonse lapansi omwe ngakhale chimfine sangathe kupikisana nawo.

Mu 5% ya odwala, antidepressant clomipramine amayambitsa kuphipha.

Matenda osowa kwambiri ndi matenda a Kuru. Oimira okha a fuko la Fore ku New Guinea amadwala naye. Wodwala amafa chifukwa cha kuseka. Amakhulupirira kuti chomwe chimayambitsa matendawa ndicho kudya ubongo wa munthu.

Chiwerengero cha ogwira ntchito muofesi chakwera kwambiri. Izi ndizodziwika kwambiri m'mizinda yayikulu. Ntchito yamaofesi imakopa amuna ndi akazi.

Malangizo ogwiritsira ntchito Januvia, mlingo

Mankhwalawa amatengedwa mosasamala chakudya. Pakusowa mankhwalawa ayenera kumwedwa mwachangu. Kugwiritsa ntchito mlingo wowirikiza sikovomerezeka.

Malangizo ofunikira ogwiritsira ntchito kipimo cha Januvia ndi monotherapy, komanso kuphatikiza ndi metformin kapena agonist wa PPARγ (thiazolidinediones) - piritsi 1 100 mg 1 nthawi patsiku.

Ndi CC - 30-50 ml / min, plasma creatinine 1.7-3 mg / dl (kwa amuna), 1.5-2.5 mg / dl (kwa akazi), mlingo umachepetsedwa mpaka 50 mg 1 nthawi patsiku.

Ndi CC ochepera 30 ml / mphindi, plasma creatinine wopitilira 3 mg / dl (mwa amuna) komanso oposa 2,5 mg / dl (mwa akazi), komanso kwa odwala omwe ali ndi vuto la matenda aimpso omwe amalephera hemodialysis, mlingo ndi 25 mg / 1 nthawi patsiku (mosasamala nthawi ya hemodialysis).

Malangizo apadera

Panthawi ya mayesero azachipatala, kuchuluka kwa hypoglycemia pakugwiritsa ntchito kunali kofanana ndi kwa placebo.

Odwala omwe ali ndi kulipidwa kwa hepatic osakwanira safunikira kuti asinthe mlingo wa mankhwalawa.

Zotsatira zoyipa

Malangizowa amachenjeza za mwayi wopanga zotsatirapo zoyipa mukamapereka Januvius:

• Matenda opatsirana thirakiti, nasopharyngitis.
• Mutu.
• Kupweteka kwam'mimba, kutsegula m'mimba, kusanza, nseru.
• Arthralgia.
• Hypoglycemia.
• Zambiri zasayansi: kuchuluka kwa uric acid, kuchepa pang'ono kwa kuchuluka kwa zamchere phosphatase, kuchuluka kwa neutrophils.

Contraindication

Amakanizidwa kuti apereke Januvius pazochitika zotsatirazi:

• Mtundu woyamba wa shuga
• Mimba komanso kuyamwa
• Matenda a shuga ketoacidosis
• Hypersensitivity pamagawo a mankhwala,
• Zaka mpaka 18.

Fotokozerani mosamala:

Bongo

Pakakhala vuto la bongo, kugunda kwa mtima kumasintha.

Ngati mavuto akuwonetseredwa kapena zizindikiro zina zowoneka zikupezeka, ndikofunikira kufunsa dokotala kuti mupeze chithandizo chanthawi yake.

Analogs a Januvius, mtengo m'masitolo ogulitsa mankhwala

Ngati ndi kotheka, mutha kusintha mapiritsi a Januvia ndi analogue yogwira ntchito kapena achire - awa ndi mankhwala:

Mukamasankha analogi, ndikofunikira kumvetsetsa kuti malangizo ogwiritsira ntchito Januvia, mtengo ndi kuwunika sizigwira ntchito ndi mankhwala omwe ali ndi vuto lofananalo. Ndikofunikira kupeza upangiri wa dokotala komanso kuti usasinthe popanda mankhwala.

Mtengo m'mafakitoreti aku Russia: Januvia 100 mg 28 mapiritsi - kuchokera 1570 mpaka 1699 ma ruble, malinga ndi 703 pharmacies.

Sungani ku 30 ° C. Pewani kufikira ana. Moyo wa alumali ndi zaka 2.

Hypoglycemic mankhwala Januvia - malangizo ntchito

Mankhwala osokoneza bongo a shuga ndi osiyanasiyana. Izi zikuphatikiza ndi mankhwala a Januvia.

Kupambana kwa chithandizo chazachipatala kumadalira kutsatira malangizo, chifukwa chake muyenera kudziwa zomwe malamulo ake ndi.

Izi zimapangidwa ku Netherlands. Ndi piritsi lokhala ndi hypoglycemic effect, yopangidwa pamaziko a Sitagliptin. Mankhwalawa atha kugulidwa kokha ndi mankhwala.

Kuphatikizika, mawonekedwe omasulidwa

Gawo lalikulu la mankhwalawa ndi sitagliptin. Ndi zochita zake zomwe zimapangitsa kuti mankhwalawa akhale othandiza mu shuga. M'mafakitare mungapeze ndalama zingapo - molingana ndi kuchuluka kwa zinthu zomwe zimagwira. Itha kukhala ndi 25, 50 ndi 100 mg.

Zothandizira zotsatirazi zimawonjezeredwa kwa izi:

• sodium walaryl fumarate,
• calcium hydrogen phosphate,
• cellcrystalline mapadi,
• sodium croscarmellose,
• olimba ndi magnesium,
• macrogol
• titanium dioxide
• talcum ufa.

Mapiritsi ndi ozungulira, biconvex. Mtundu wawo ndi wa beige, lililonse lojambula "277". Amayika m'matumba a contour mochuluka 14 ma PC. Mtolo wa makatoni ukhoza kukhala ndi phukusi zingapo (2-7).

Pharmacology ndi pharmacokinetics

Zomwe zimapangitsa kuti mankhwalawo akhale pa thupi chifukwa cha zomwe zimagwira. Sitagliptin (formula pachithunzichi) amathandizira kuti insulini ipangike mwachangu, chifukwa choti shuga yomwe imalandilidwa m'thupi imagawidwa mwachangu.

Kuwonjezeka kwa kuchuluka kwa insulin kaphatikizidwe kumakhudza chiwindi, kuwaletsa kupanga shuga wambiri. Izi zimapereka kuchepa kwa kuchuluka kwa shuga m'magazi a anthu odwala matenda ashuga ndipo zimamuthandiza kukhala bwino.

Mafuta a yogwira amapezeka mwachangu kwambiri. Gawoli limakwaniritsa mphamvu yake pafupifupi ola limodzi mutatha kudya Januvia ndikumatha maola ena atatu. Komanso, thupilo limayamba kuchoka m'thupi pang'onopang'ono, ndipo zotsatira zake zimafooka.

Kuyankhulana ndi mapuloteni a plasma amapanga kuchuluka pang'ono kwa sitagliptin. Ndi metabolism, chigawocho sichimasandulika. Kuchotsa gawo lina lake kumachitika ndi impso. Kuchulukitsa kumachotsedwa ndowe.

Zizindikiro ndi contraindication

Malinga ndi malangizo, mankhwalawa amathandiza ndi matenda a shuga a 2. Itha kugwiritsidwa ntchito limodzi ndi mankhwala ena kapena monga monotherapy, yomwe imathandizidwa ndi chakudya.

Koma kupezeka kwa matendawa sikutanthauza kuti muyenera kuyamba kumwa mankhwalawa. Mankhwalawa ayenera kuyikidwa ndi adokotala atawunika ndikufotokozera mwatsatanetsatane malamulo ogwiritsira ntchito. Izi ndizofunikira chifukwa Januvia ali ndi contraindication, zomwe zimapangitsa kukhala koopsa kugwiritsa ntchito.

Pakati pawo amatchulapo:

• ketoacidosis wodwala matenda ashuga,
• mtundu 1 shuga
• tsankho pakuchokera,
• ana ndi achinyamata,
• mimba
• nthawi yoyamwitsa.

Palinso zochitika zina zomwe malonda angagwiritsidwe ntchito, koma kusamala ndikofunikira. Nthawi zambiri, njira zapadera zimaperekedwa kwa odwala omwe ali ndi matenda a impso.

Katswiri amatha kuwalembera Januvia kwa iwo, koma ayenera kukhala ndi udindo pakusankha mankhwalawa. Kuphatikiza apo, muyenera kuyang'ana nthawi ndi nthawi momwe impso zimagwirira ntchito.

Odwala apadera

Kwa odwala ena, sibwino kugwiritsa ntchito malamulo apakompyuta ambiri. Ali ndi mawonekedwe apadera. Oimira pamagulu ena saloledwa kulandira Januvia; chisamaliro chapadera chimafunikira mogwirizana ndi ena.

1. Amayi oyembekezera. Palibe chidziwitso cha momwe mankhwalawa amathandizira odwala otere, chifukwa maphunziro m'derali sanachitike. Pofuna kupewa zoopsa, ndi shuga mwa amayi apakati, madokotala amatenga mankhwala ena.
2. Amayi oyamwitsa. Sizikudziwika ngati zosakaniza zikupita mkaka wa m'mawere. Pankhaniyi, ndizovuta kudziwa momwe mankhwalawa angakhudzire mwana. Chifukwa chake, ndi mkaka wa mkaka, ndizosatheka kugwiritsa ntchito Januvia.
3. Ana ndi achinyamata. Malangizo a mankhwalawa samapereka chithandizo kwa odwala omwe ali ndi zaka zosakwana 18. Chifukwa chake, odwala matenda ashuga amathandizidwa ndi njira zina.
4. Anthu okalamba. Sitagliptin sitiwowona ngati yowopsa kwa anthu omwe ali mgululi. Pakakhala mavuto azachipatala, ndondomeko yanthawi zonse yomwe timamwa mankhwalawa imaloledwa, ngakhale pakhale kusintha kwokhudzana ndi zaka. Koma adotolo amayenera kuyang'anitsitsa njira ya chithandizo makamaka mosamala.

Nthawi zina, zimadalira chithunzi cha matenda ndi mawonekedwe a thupilo.

Kuyanjana Ndi Mankhwala Ndi Analogi

Ngati wodwalayo alibe matenda ashuga okha, ndiye kuti chithandizo chake chimafuna chisamaliro chapadera. Sikuti mankhwalawa amatha kuphatikizana, nthawi zina kugwiritsidwa ntchito kwa mankhwala ena kumabweretsa zosokoneza zochita zawo.

Januvia amadziwika kuti ndi wotetezeka pankhaniyi, chifukwa mankhwalawa sakhala ndi phindu lililonse.

Kusintha kocheperako pakuchitika kwake kumachitika ndi munthawi yomweyo kugwiritsa ntchito mankhwalawa ndi digoxin ndi cyclosporine. Kutengera momwe adasinthira kusintha kumeneku, mlingo wake umasankhidwa.

Popeza mankhwalawa ndi okwera mtengo, odwala amafunsidwa kuti awapatse analogi zotsika mtengo.

Akatswiri amasankha iwo njira izi:

Dokotala aliyense amayenera kupereka iliyonse mwa mankhwalawa atasanthula wodwalayo. Kupanda kutero, kukula kwa zovuta kumatha kupweteketsa. Ndikofunikanso kutsatira malamulo osamutsa wodwala kuchokera ku mankhwala ena kupita kwina.

Maganizo a madotolo ndi odwala

Poona ndemanga, madokotala samapereka mankhwala kwa Januvia makamaka chifukwa cha kukwera mtengo kwa mankhwalawa. Mwa odwala, mankhwalawa samatchuka kwambiri chifukwa cha mtengo wokwera ndi zoyipa zake.

Ndinasankha Januvius maulendo ochepa okha. Awa ndi mankhwala abwino omwe amatsitsa shuga m'magazi. Koma ndiokwera mtengo kwambiri, ndipo odwala nthawi zambiri amakana. Iwo omwe amapereka kwaulere kapena pamtengo wokonda, samakhuta nthawi zonse, chifukwa ali ndi zotsatira zoyipa. Tsopano, mosalekeza, odwala anga awiri okha ndi omwe amagwiritsa ntchito mankhwalawa. Amawakwanira kuposa mankhwala ena.

Elena Dmitrievna, dokotala

Gwiritsani ntchito mankhwalawa pokhapokha pofufuza mwatsatanetsatane. Contraindication osadziwika amabweretsa zotsatira zoyipa, odwala amavutika ndi zotsatirapo zake, ndipo zotsatira zake ndi zero. Koma kwa iwo omwe mankhwalawo ndi oyenera nthawi zambiri amakhuta nawo, amangodandaula za mtengo wokwera. Onse payekhapayekha.

Alexander Borisovich, dokotala

Sizinatenge Januvia nthawi yayitali. Mankhwala ndi abwino, shuga amasungidwa bwino komanso popanda mavuto. Koma ndiokwera mtengo kwambiri, ndimakonda ma analogue otsika mtengo.

Poyamba ndinkafuna kusiya mankhwalawa. Ndinkazunzidwa ndi kusowa tulo komanso kufooka mosalekeza chifukwa chosowa tulo. Shuga adabweranso kwakhalidwe, koma ndidamva bwino kwambiri. Ndipo kenako idapita - zikuwonekeratu kuti thupi limagwiritsidwira ntchito kwa icho. Tsopano zonse zandikwana.

Mtengo wa Januvia umakhudzidwa ndi kuchuluka kwa zinthu zomwe zimagwira komanso kuchuluka kwa magawo omwe ali phukusili. Paketi yokhala ndi mlingo wa Sitagliptin mu 100 mg (28 ma PC.), Muyenera kupatsa ma ruble 2200-2700.