Saxagliptin kwa odwala matenda ashuga - malangizo ogwiritsira ntchito

Mankhwala omwe ali ndi mankhwala othandizira - saxagliptin amagwiritsidwa ntchito pochiza matenda a shuga 2. Amathanso kuphatikizidwa ndi mankhwala ena ochepetsa shuga kuti athandizire kuthandizira. Nkhaniyi ikuthandizani kuti muphunzire za zinthu zazikulu zomwe zimapangidwira, zikuwonetsa, zotsutsana, zosokoneza, mankhwala omwe ali ndi saxagliptin, ndemanga za anthu odwala matenda ashuga ndi mankhwala ofanana.

Masiku ano, matenda a shuga a mtundu wachiwiri amathandizidwa chifukwa cha zinthu zingapo: kudya moyenerera, kuchita masewera olimbitsa thupi, kuyang'anira shuga wamagazi nthawi zonse. Malo apakati pakuthandizira matendawa ndi kugwiritsa ntchito mankhwala osokoneza bongo.

Kugwiritsa ntchito kwa Onglisa kapena Saxagliptin, Metformin palimodzi kumathandizira kukula kwa shuga mwa wodwalayo. Ndemanga za mankhwalawa zabwino.

Chokhacho chomwe chingabwezeretse ndi mtengo wokwera wa mankhwala a Ongliza ndi mitundu yake. Kuonetsetsa njira yothandizira kwambiri yachipatala komanso kupewa zovuta zambiri, mankhwalawa amayenera kumwedwa mosamala ndi dokotala.

Katundu wa zomwe zimagwira

Saxagliptin ndi chosinthira chosankha chosinthika dipeptidyl peptidase-4 (DPP-4). Pogwiritsa ntchito mankhwalawa odwala omwe ali ndi matenda a shuga 2, ntchito ya DPP-4 enzyme imachepa masana.

Wodwala akangotenga shuga, kuchuluka kwa glucagon kumachepetsedwa kwambiri. Nthawi yomweyo, pali kutulutsidwa kwa mahomoni - insulin ndi kapamba, kapena ndendende - maselo ake a beta. Izi zimathandizira kuchepetsa shuga wamagazi pamimba yopanda kanthu mwa anthu.

Izi zimalumikizana ndi zinthu zambiri za hypoglycemic - metformin, glibenclamide, pioglitazone, ketoconazole, simvastatin kapena dithiazem. Koma kugwiritsa ntchito limodzi ndi ma inducers ena a CYP3A4 / 5 isoenzymes, mwachitsanzo, ketoconazole, itraconazole, indinavir ndi ena, kungachepetse mphamvu ya achire mphamvu ya saxagliptin.

Mu maphunziro ambiri, asayansi sanathe kudziwa mphamvu yapadera ya saxagliptin pa lipid mbiri. Pogwiritsa ntchito mankhwalawa, palibe kulemera kwakanthawi komwe kumawonetsedwa mwa wodwala aliyense wodwala matenda a shuga 2.

Tiyenera kudziwa kuti asayansi sanachitepo kafukufuku wokhudzana ndi kukhudzidwa kwa zinthu za hypoglycemic pazinthu monga kusuta fodya, mowa, kudya, komanso kugwiritsa ntchito mankhwala azitsamba.

Chifukwa chake, anthu omwe ali ndi zizolowezi zoyipa komanso kumwa mankhwala achilengedwe ayenera kumwa mankhwalawa mosamala kwambiri.

Malangizo ogwiritsira ntchito mankhwalawa

Mankhwala odziwika omwe ali ndi yogwira - saxagliptin ndi Onglisa.

Imapezeka mu mapiritsi a 5 mg. Phukusi limodzi lili ndi zidutswa 30.

Amatengedwa mosasamala chakudyacho, kutsukidwa ndi madzi pang'ono.

Zizindikiro zazikulu zogwiritsidwa ntchito kwa mankhwalawa Onglisa, momwe saxagliptin ndiye chinthu chachikulu cha hypoglycemic, amatengedwa:

1. Type 2 shuga mellitus, ngati zakudya ndi masewera olimbitsa thupi sizingakhudze kutsika kwa shuga wamagazi, monga monotherapy.
2. Monga chida china chowonjezera cha metformin koyambirira kwamankhwala kuti mugwiritse ntchito njira ya hypoglycemic.
3. Kuphatikiza pa monotherapy ndi metformin, sulfonylureas, thiazolidinediones, ngati sizingatheke kuyendetsa bwino shuga.

Musanayambe chithandizo, malangizo a mankhwalawa ayenera kuphunziridwa mosamala. Dokotala wokhayo amene angakupatseni mankhwala omwe mungamwe ndi mankhwalawa, simungagule popanda mankhwala. Ndi monotherapy kapena kuphatikiza ndi njira zina, wodwalayo amangodya zosaposa 5 mg za mankhwala Onglisa patsiku. Pa gawo loyamba la chithandizo ndi saxagliptin, Metformin imatengedwa patsiku pa 500 mg. Ngati wodwalayo wayiwala kuti ndikofunikira kumwa piritsi la Onglisa, izi ziyenera kuchitika mwachangu. Kwa magulu ena a odwala, mlingo wa tsiku ndi tsiku umatha kuchepetsedwa mpaka 2,5 mg. Awa ndi, choyamba, anthu omwe ali ndi hemodialysis komanso kulephera kwa impso. Nthawi yomweyo, Ongliz amayenera kumwedwa atangomaliza njira ya hemodialysis.

Mapiritsi amasungidwa kuti ana asawatenthedwe kutentha kosakwana 30C. Alumali moyo wa mankhwala ndi zaka 3.

Contraindication ndi zoyipa

Monga mankhwala ena ambiri, mankhwala a Ongliz akhoza kukhala oletsedwa.

Nthawi yomweyo, Onglisa amalembedwa ndi adokotala mosamala kwambiri kwa odwala omwe ali ndi vuto la impso, okalamba ndi odwala omwe amatenga mankhwala a sulfonylurea.

Ngati wodwalayo aphatikiza mankhwala awiri - Onglizu ndi Metformin, nasopharyngitis, kutupa kwa nasopharynx komwe kumachitika chifukwa cha matupi osagwirizana ndi matendawa. Onetsetsani kufunsa dokotala momwe mungagwiritsire ntchito Metformin ndi mankhwala ena.

Simungagwiritse ntchito mankhwalawa kwa anthu:

• osakwana zaka 18,
• mtundu 1 shuga
• kulandira insulin mankhwala ndi mankhwala,
• ndi galactose tsankho, kufupika kwa lactase, kupezeka kwa shuga-galactose malabsorption,
• ndi matenda ashuga a ketoacidosis,
• pa mimba ndi kuyamwa,
• ndi tsankho la munthu pazigawo za mankhwala.

Pa monotherapy, mankhwalawa amatha kuyambitsa mavuto ena mwa anthu, monga:

• chapamwamba kupuma thirakiti matenda
• kutupa kwamikodzo
• kusanza ndi kusanza
• mutu
• sinusitis (complication ya pachimake rhinitis),
• gastroenteritis (kutukusira kwa m'mimba ndi matumbo ochepa).

Malangizo ogwiritsidwira ntchito sakusonyeza zomwe zingachitike ndi mankhwala osokoneza bongo. Koma ngati zidachitika, chithandizo chamankhwala chimalimbikitsidwa.

Kuphatikiza apo, mankhwala a saxagliptin amatha kuchotsedwa pogwiritsa ntchito njira ya hemodialysis.

Ndemanga ndi mitengo yamankhwala

Mankhwala Onglisa akhoza kugulidwa ku pharmacy iliyonse ndi mankhwala kapena kuyitanidwa pa intaneti. Kuti muchite izi, pitani pa webusayiti ya masamba azisamba ndikutsatira malangizo kuti mupeze oda. Popeza mankhwalawa amapangidwa ku United States, mtengo wake ndi wokwera kwambiri. Mtengo wa mankhwala ochepetsa shuga umachokera ku 1890 mpaka 2045 rubles.

Ndemanga za anthu ambiri odwala matenda ashuga ndizokhutiritsa. Odwala ambiri omwe amamwa mankhwalawo amadziwa kuti amagwira ntchito kwambiri. Pambuyo pakuphunzira kumwa mapiritsi, kutsatira kadyedwe ndikuchita masewera olimbitsa thupi, kusintha kwachilengedwe kwa shuga kwa nthawi yayitali kumawonedwa. Odwala omwe amagwiritsa ntchito Ongliza amakhutira ndi kugwiritsa ntchito mankhwalawa mosavuta. Zotsatira zoyipa zawonedwa kawirikawiri. Choyipa chokha cha mankhwalawo ndi mtengo wake wokwera, chifukwa chakuti ndi mankhwala ochokera kunja.

Nthawi yomweyo, panali ndemanga za madalaivala omwe amayendetsa magalimoto omwe mankhwalawo amayambitsa chizungulire.

Chifukwa chake, anthu omwe amayanjana ndi kasamalidwe ka mayendedwe, ndibwino kusiya ntchito zawo munthawi yamankhwala kuti musapeze zoyipa.

Mndandanda wa mankhwala ofanana

Wodwala akakhala oletsedwa kugwiritsa ntchito Ongliza kapena ali ndi mavuto ena, dokotala yemwe akupezekapo amatha kusintha njira yochiritsirayo mwa kupereka mankhwala ena.

Mankhwala a Ongliz alibe machitidwe, koma malinga ndi momwe thupi la munthu limakhalira, pali mankhwala:

1. Januvia ndi mankhwala a piritsi omwe amachepetsa kuchuluka kwa shuga m'magazi. Dziko lomwe likubala ndi Netherlands. Mankhwalawa angagwiritsidwe ntchito ndi monotherapy, komanso ophatikizidwa ndi ena othandizira a hypoglycemic monga Metformin omwe samatha kudya komanso kuchita masewera olimbitsa thupi. Mosiyana ndi Onglisa, Januvia ali ndi zotsutsana zochepa. Mtengo wapakati ndi ma ruble 1670.
2. Trazenta imakhala ndi yogwira mankhwala linagliptin, yomwe imachepetsa shuga. Mankhwalawa amapangidwa ku United States. Monotherapy pankhaniyi siyothandiza, mankhwalawa amagwiritsidwa ntchito limodzi ndi mankhwala ena ochepetsa shuga (Metformin, insulin, sulfonylureas, Pioglitazone, etc.). Komabe, mankhwalawa amadziwika kuti ndi otetezeka, chifukwa samayambitsa mavuto. Mtengo wapakati ndi ma ruble 1790.
3. Nesina ndi mankhwala ochepetsa matenda a shuga. Wopanga mankhwalawa ndi kampani ya zamankhwala ku America Takeda Pharmaceuticals. Wothandizira wa hypoglycemic amagwiritsidwanso ntchito ndi monotherapy komanso ndi chithandizo chowonjezera ndi mankhwala ena. Nthawi zambiri, zotsatira zoyipa zomwe zimakhudzana ndi matenda am'mimba zimachitika. Mtengo wapakati pama pharmacies ndi 965 rubles.
4. Galvus ndi mankhwala ena othandizira odwala matenda ashuga. Zimapangidwa ndi kampani yaku Swiss mankhwala. Mankhwalawa amatha kugwiritsidwa ntchito ndi mankhwala a insulin komanso mankhwala ena ambiri ochepetsa shuga. Ili ndi zotsutsana zambiri, koma milandu yotsutsa imasinthidwa kukhala zero. Mtengo wapakati ndi ma ruble 800.

Komanso, odwala matenda ashuga nthawi zambiri amapatsidwa Metformin 850 kapena mlingo wa 1000 mg.

Tiyenera kudziwa kuti palibe mankhwala omwe ali pamwambawa omwe angagwiritsidwe ntchito paubwana (mpaka zaka 18), popeza momwe adagwiritsira ntchito mankhwalawa sanaphunzire. Mankhwala onse ndi okwera mtengo ndipo si wodwala aliyense amene angakwanitse.

Kanemayo munkhaniyi akukamba za mapiritsi ochepetsa shuga.

Njira zakuchitikira ma insretins

Ma insretins ndi mahomoni amunthu. Matumbo awo am'mimba amatulutsa pambuyo pakudya, insulin katemera pakadali pano amawonjezeka ndi 80%. Mitundu iwiri yaiwo idazindikilidwa m'thupi - GLP-1 (glucone-like peptide-1) ndi HIP (insulinotropic polypeptide). Ma receptors omalizirawo amapezeka pa ma b-cell, ndipo mu GLP-1 amatha kupezeka mu ziwalo zosiyanasiyana, chifukwa chake ntchito yake ndi multivariate.

1. GLP-1 imathandizira kupanga insulin ya insulin mwa mab-cell,
2. Homoni imalepheretsa kubisalira kwa glucagon ndi ma cell a b,
3. Incretin amachepetsa m'mimba,
4. Imachepetsa chilakolako chofuna kudya ndipo imapangitsa munthu kumva kuti ndi wokwanira,
5. Zothandiza pa chapakati mantha dongosolo, mtima, mitsempha.

Glucose-wodalira insulin katulutsidwe, ngati shuga ali wabwinobwino, kukondoweza kwa kupanga kwa maimidwe kumayima, kotero hypoglycemia siopseza thupi.

Glucagon, yomwe imapangidwa m'chiwindi cha b-cell, ndizomwe ndizofanana ndi insulin. Zimawonjezera kuchuluka kwa shuga m'magazi mwakuwamasula ku chiwindi.

Minofu imafunika glucose kuti ikwaniritse nkhokwe zamphamvu, pomwe ilipo mwa mtundu wa glycogen. Poletsa kuphatikiza kwa glucagon, mahomoni amtunduwu amatchinga kutulutsa shuga m'magazi, ndikungokulitsa kutulutsa kwa insulin.

Kodi pali phindu lanji kuyamwa kaye m'mimba kwa wodwala matenda ashuga? Thupi limamwa glucose wambiri m'matumbo. Ngati iperekedwamo m'malo yaying'ono, sipadzakhala madontho akuluakulu a shuga. Izi zimathandiza kuthana ndi vuto la postprandial (masana) glycemia. Ndikosatheka kuphatikiza kudya kwakukonda kwa 2 shuga: GLP-1 imakhudza mwachindunji gawo lanjala mu hypothalamus.

Phindu la ma impretins pamtima ndi m'mitsempha yamagazi tsopano akuphunzira mwachangu. Muholo yofufuzira, zidapezeka kuti GLP-1 imathandizira kusinthika kwa maselo a pancreatic, komanso kuteteza maselo a b kuti asawonongeke.Ndi chiyani chomwe chimaletsa kugwiritsa ntchito mahomoni achilengedwe m'malo mwa mankhwala? GLP-1 imawonongedwa ndi DPP-4 (mtundu wa 4 dipeptidyl peptidase) m'mphindi 2, ndi HIP - mu maminiti 6.

Asayansi apeza magulu awiri a mankhwala ofanana ndi maretretin:

• Kuyesa machitidwe a GLP-1,
• Kuletsa ntchito ya enzyme DPP-4 ndikukulitsa moyo wa mahomoni.

Mtundu woyamba umaperekedwa pamsika wapanyumba ndi Bayeta (kutengera exenatide) ndi Viktoza (kutengera liraglutide) - analogues wa GLP-1, yomwe imatanthauzira kwathunthu makulidwe ake, koma ndi zotsatira zake zotalikilapo. Zabwino zake zimatha kuwonjezeredwa ndikuchepera makilogalamu 4 kwa miyezi isanu ndi umodzi ndikuchepa kwa hemoglobin wa glycated ndi 1.8%.

Mtundu wachiwiri ukuimiriridwa pano ndi mankhwala atatu - Galvus (kutengera vildagliptin), Yanuviya (motengera sitagliptin), Onglisa (mu kapangidwe kake - saxagliptin). Ntchito yawo yayikulu ndikuletsa enzyme DPP-4, yomwe imawononga ma protein. Ntchito yamahomoni imachulukitsa nthawi ziwiri, motero glycemia siziwopseza munthu. Ma Inhibitors ali ndi zotsatira zosasangalatsa zingapo, chifukwa mahomoni amakula m'thupi.

Zotsatira za kulemera kwawo sizilowerera ndale, glycated hemoglobin imachepetsedwa chimodzimodzi monga gulu loyamba.

Fomu yotulutsa katundu

Saxagliptin ndiye mankhwala aposachedwa kwambiri a kalasi ya DPP-4 inhibitors. Dzina lake la malonda ndi Onglisa. Amatulutsa mankhwalawa Mlingo wa 2,5 ndi 5 mg, amagulitsa mapiritsi. Alumali moyo wa mankhwala ndi zaka 3, malo osungirako ali muyezo.

Saxagliptin sakuphatikizidwa pamndandanda wabungwe la mankhwala omwe amakondweretsedwa, ngakhale m'madera ena amalembedwa pamaziko a registry registe kuchokera ku bajeti yakomweko. Kuti mupeze chithandizo cha Onglisa pamitengo yamapulogalamu apakompyuta, muyenera kugwiritsa ntchito ma ruble 1700. pamwezi (mapiritsi a 5 mg). Poyerekeza - maphunziro a pamwezi a Januvia (mlingo wa 100 mg) adzagula ma ruble 2,400., Galvus - 900 rubles.

Malangizo ogwiritsira ntchito

Malangizo a Saksagliptin ogwiritsira ntchito akutsimikiza kuti mutenge 1p / tsiku., Dongosolo silimamangidwa pakudya. Mutha kugwiritsa ntchito chida cha monotherapy kapena mawonekedwe ovuta.

Mankhwala ophatikiza saxagliptin ndi metformin sanapangidwebe, ngati fanizo lake YanuMet ndi GalvusMeta.
Pazovuta zazing'onoting'ono, simuyenera kusintha mankhwalawa; milandu yayikulu kwambiri, kuchuluka kwake kumachepetsedwa ndi 2 times.

Ndani amasankhidwa Saxagliptin

Mankhwala opangidwa ndi Saxagliptin (mawu ofanana - Onglisa) amatha kutumikiridwa ngakhale pa gawo la prediabetes ya mtundu wa 2, pomwe kusinthidwa kwa njira yamoyo (kadyedwe kakang'ono ka carb, zochitika zolimbitsa thupi zokwanira, kuwongolera kwamtima) sikupereka shuga m'magazi.

Munthawi imeneyi, ndikofunikira kupulumutsa ndikuwonjezera kuchuluka kwa ma b-cell, ndiye kuti glycemia ikhoza kulipidwa kwa nthawi yayitali popanda jakisoni wa insulin.

Saxagliptin ndi yoyeneranso chithandizo chovuta, makamaka kuchuluka kwa mankhwalawa omwe adzafotokozedwenso panthawi imodzi atapezeka kuti akudwala kumadalira hemoglobin wa glycated. Kufanana ndi Ongliza, metformin imayikidwa, ndipo pakakhala kuti palibe machitidwe owongolera glycemic, mndandanda wamtundu wa sulfonylurea ndi thiazolidatediones amapatsidwa.

Zotsatira zoyipa ndi bongo

Saxagliptin ndiye wothandizira kwambiri pa hypoglycemic, chifukwa samayambitsa hypoglycemia, koma, ngati mankhwala aliwonse opangidwa, amatha kukhala ndi zotsatirapo zosayenera. Ngati zizindikirozi kapena vuto lililonse likuwoneka, muyenera kufunsa dokotala: amasintha mankhwalawo kapena asinthe m'malo mwake.

Zina mwazomwe zimachitika mosayembekezereka:

• Matenda opatsirana
• Kutupa kwa ma genitourinary system,
• Matenda a Dyspeptic
• Mutu
• Sinusitis
• Gastroenteritis

Malangizowo sanena za mankhwala osokoneza bongo, chifukwa maphunziro azaukachipatala omwe mankhwalawo adaperekedwa kwa odzipereka odzipereka mu Mlingo wopitilira muyeso nthawi 80 sizinawonetse kuledzera.

Malangizo apadera ndi othandizira komanso othandizira. Mutha kuwonetsa incretinomimetics ndi hemodialysis.

Zitha kusintha saxagliptin

Mopanda kulekerera kapena contraindication, dokotala amasankha ma fanizo a saxagliptin. Palibe njira ina yomwe mungagwire Onglise ndi gawo lomweli, koma malinga ndi momwe agwirira ntchito, ukali wa enzyme ya DPP-4 udatsekedwa:

1. Januvia ndiye mankhwala oyamba m'kalasi lino, omwe ankangogwiritsidwa ntchito ku USA kokha, kenako ku Europe. Hafu ya ola mutatha kudya, mankhwalawa amalepheretsa enzyme kwa tsiku limodzi. Mutha kugula mapiritsi pa 25,50 ndi 100 mg. Mlingo wokhazikika ndi 100 mg / tsiku. Zotsatira zake zikuwonekera patatha mwezi umodzi. Kuti muthane ndi zovuta mankhwala, mankhwalawa amapangidwa limodzi ndi metformin - YanuMet.
2. Galvus ndi mankhwala othandizira aku Swiss, oyenera kulandira chithandizo chovuta, kuphatikiza ndi insulin. Mankhwala ophatikizidwa a GalvusMet nawonso amatulutsidwa, kapangidwe kake kamathandizidwa ndi metformin. Choyamba, mapiritsi amatengedwa pa 50 mg / tsiku .. Ngati ndi kotheka, mulingo umachulukitsa, ndikugawa mu 2 waukulu.

Kuchita bwino ndi chitetezo cha mankhwala onse omwe ali mgululi ndi ofanana, kusankha kwa mankhwala ena kumadalira luso lazachipatala la wodwalayo komanso chidziwitso cha endocrinologist ndi mankhwalawa. Kwa saxagliptin, mtengo ndiwofunikira kwambiri poyerekeza ndi analogues.

Saxagliptin yozikidwa palagis, njira zaposachedwa kwambiri za akatswiri azachipatala aku Europe pankhani ya matenda ashuga, sikuti amangokhala hypoglycemic, komanso amakhalanso ndizotsatira zina zowonjezera: zimachepetsa chilimbikitso ndi kulemera, zimateteza kapamba, zimathandizira kuwongolera kuthamanga kwa magazi, komanso zimatha kukhala ndi mtima.

Mutha kudziwa zambiri za ma insretin komanso kuthekera kwa mankhwala ochepetsa mphamvu ya kachilomboka potengera iwo a Dilyara Lebedeva wa webusaitiyi wa vidiyoyi.

Saxagliptin kwa odwala matenda ashuga - malangizo ogwiritsira ntchito

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

Palibe zovuta kuganiza kuti zaka 100 zapitazo kunalibe insulin, ndipo odwala matenda ashuga adatsimikizika kuti afa mwachangu. Mankhwala ochepetsa shuga a matenda ashuga a mtundu 2 adawonekera mkatikati mwa zaka zana zapitazo, ndipo izi zisanachitike, odwalawa nawonso anamwalira, ngakhale sanachedwe kwambiri.

Masiku ano pa intaneti pali zambiri zokhudzana ndi mankhwala atsopano, njira zamankhwala, zida zawo

Chimodzi mwazatsopano zamankhwala osokoneza bongo a antidiabetic ndi incretinomimetics (exenatide, liraglutide, sitagliptin, vildagliptin, saxagliptin). Kodi mapindu a shuga ndi otani?

Mankhwala atsopano pochiza matenda a shuga a 2

Type 2 matenda a shuga a mellitus (T2DM) ndi matenda omwe amachepetsa mphamvu ya maselo kupita ku insulin, chifukwa chake glucose amasiya kulowa nawo ndikukhazikika m'magazi. Ngati palibe njira zomwe zimatengedwa, ndiye kuti shuga ya 1 imayamba, yomwe imadziwika ndi kuwonongeka kwa maselo a pancreatic beta omwe amapanga insulin. Ndipo mudzayenera kukonzekera insulin yokonzekera moyo, yomwe imathandizira thupilo mozungulira.

Pazifukwa izi, chithandizo chikuyenera kuyamba kuyambira tsiku loyamba la T2DM. Kuti muchite izi, imwani mankhwala apadera omwe amachititsa kuti maselo azikhala ndi insulin. Tsopano tikambirana mndandanda wam'mapiritsi am'badwo watsopano wa matenda a shuga 2, omwe nthawi zambiri amagwiritsidwa ntchito ngati mankhwala ochizira matendawa. Koma! Zimaperekedwa pazidziwitso zokhazokha. Simungamwe mankhwala ena alionse popanda kuikidwa ndi dokotala!

Gulu la mankhwala

Ndi chitukuko cha matenda ashuga amtundu 2, odwala samalandira mankhwala mwachangu. Pongoyambira, kudya mokhazikika komanso kuchita masewera olimbitsa thupi mokwanira kuti muziwongolera shuga. Komabe, zochitika ngati izi sizimapereka zabwino nthawi zonse. Ndipo ngati siziwoneka mkati mwa miyezi iwiri, tengani chithandizo chamankhwala.

Mankhwala onse ochizira matenda a shuga amagawika m'magulu angapo:

• chinsinsi, chimalimbikitsa kuphatikiza kwa insulini ndi ma cell a beta a kapamba, amagawidwa kukhala sulfonylureas ndi megoitinides,
• masisitimu, omwe amathandizira kukulitsa chidwi cha maselo amthupi kuti apange insulini, ali ndi magawo awiri - biguanides ndi thiazolidinediones,
• alpha-glucosidase zoletsa zomwe zimapangitsa kuti pakhale kusweka, mayamwidwe ndi michere yamafuta m'thupi,
• maretretin, omwe ndi mankhwala obwera kumene omwe ali ndi zotsatira zingapo mthupi.

Sulfonylureas

Mankhwala a gulu lachipatalawa agwiritsidwa ntchito ngati mankhwala ochizira matenda ashuga kwa zaka zoposa 50. M'mapangidwe awo amakhala ndi zinthu zomwe zimatsimikizira kuti shuga la magazi limasinthika chifukwa cha ma cell a beta omwe amaphatikizidwa ndikupanga insulin. Zotsatira zake, kukhazikika kwake m'magazi kumawonjezeka ndikumverera kwa maselo mwachindunji kukuchulukana kwa glucose.

Kuphatikiza apo, zotumphukira za sulfonylurea zimabwezeretsa maselo a impso ndikuwonjezera mamvekedwe a makoma otupa, motero kuchepetsa chiopsezo cha mitundu yosiyanasiyana ya matenda a T2DM.

Komabe, mankhwalawa ali ndi mphamvu yochepa yochiritsa. Kugwiritsira ntchito kwawo kwa nthawi yayitali mu mtundu 2 wa shuga kumatsitsa pancreatic cell, potero kumapangitsa kukula kwa matenda a shuga 1. Kuphatikiza apo, nthawi zambiri zimayambitsa matupi awo sagwirizana, mavuto am'mimba komanso chithokomiro cha hypoglycemic.

The contraindication waukulu kumwa mankhwala a gulu la sulfonylurea zotumphukira ndi awa mikhalidwe ndi matenda:

• mimba
• kuyamwa
• ana osakwana zaka 12,
• matenda ashuga kapamba.

Pakati pazomwe zimachokera ku sulfonylurea, zotchuka kwambiri ndi:

• Glycidone. Chimagwiritsidwa ntchito makamaka pochiza matenda a shuga a 2 okalamba. Imakhala ndi zolakwika zochepa ndipo sizimakwiyitsa maonekedwe. Mbali yodziwika bwino ya mankhwalawa ndikuti imatha kuchitika ngakhale pakhale matenda monga kulephera kwa impso.
• Maninil. Mankhwalawa ndi amodzi abwino kwambiri, chifukwa amatha kusunga shuga m'magazi mkati mwa tsiku limodzi. Amapezeka mu mitundu yosiyanasiyana ndipo angagwiritsidwe ntchito pochiza T1DM ndi T2DM.
• Diabetes. Imakulitsa katemera wa insulin ndipo imalimbitsa mtima. Amagwiritsidwa ntchito mu shuga monga adjunct therapy.
• Amaril. Mankhwalawa nthawi zambiri amaperekedwa kwa matenda amiseche amtundu woyamba komanso wachiwiri, makamaka kwa okalamba. Chachilendo chake ndikuti sichimakhala ndi zotsutsana komanso zoyipa, komanso zimalepheretsa kuyambika kwa hypoglycemic coma chifukwa chotulutsa pang'onopang'ono insulin m'magazi.

Mankhwalawa a mtundu wachiwiri wa shuga ndiwofala kwambiri m'zochita zachipatala, chifukwa nthawi zambiri amachititsa kuti thupi lizikula komanso kunenepa kwambiri, komwe kumakulitsa matenda.

Meglitinides

Mankhwala ochokera pagululi la pharmacological amapereka kukondoweza kwa kapangidwe ka insulin. Fananizani ndi m'badwo watsopano wamankhwala amshuga, kugwira ntchito kwake komwe kumadalira kuchuluka kwa shuga m'magazi. Momwe ziliri, ndizochulukirapo zomwe zimakhala ndi insulin.

Gulu la mankhwalawa limaphatikizapo Novonorm ndi Starlix. Chachilendo chawo ndikuti amachita zinthu mwachangu kwambiri komanso amateteza kuti pasachitike vuto la hyperglycemic komanso kuwonjezeka kwambiri kwa shuga m'magazi. Komabe, zotsatira zake zimapitilira kwakanthawi.

Mankhwalawa a mtundu wachiwiri wa ashuga ali ndi zovuta zingapo. Nthawi zambiri amapangitsa maonekedwe a:

• thupi lawo siligwirizana monga urticaria,
• kupweteka m'mimba
• kutsegula m'mimba
• ukufalikira
• nseru

Mlingo wa Novonorm ndi Starlix amasankhidwa payekha. Njira yoyamba imawerengedwa katatu patsiku, musanadye, kachiwiri - theka la ola musanadye.

Mankhwala ochokera pagululi nthawi zambiri amalembera anthu omwe ali ndi matenda a shuga a mtundu wachiwiri. M'mapangidwe awo mumakhala zinthu zomwe zimalimbikitsa kutulutsa shuga kwa chiwindi, kusintha mayamwidwe ake ndikulowa m'maselo a thupi. Komabe, ali ndi drawback imodzi yayikulu - sangatengedwe ndi matenda a impso ndi mtima. Koma ndi iwo okhawo omwe amapezeka nthawi zambiri odwala matenda ashuga.

Biguanides amachepetsa glucose wamagazi ndipo amatha kuisunga kwakanthawi pafupifupi maola 16. Nthawi yomweyo, zimasokoneza kuyamwa kwa matumbo ndi matumbo, potero zimalepheretsa kuchitika kwa mapangidwe a atherosselotic m'matumbo.

Mankhwala otsatirawa ndi a gulu lachipatalichi:

• Siofor. Amapereka njira yodziwika bwino ya kagayidwe kazakudya ndi kuchepa thupi, chifukwa chake nthawi zambiri imafotokozedwa kwa anthu omwe ali ndi thupi lolemera. Mlingo umasankhidwa payekha.
• Metformin. Amagwiritsidwa ntchito limodzi ndi insulin pokonzekera komanso ngati kunenepa kwambiri. Contraindified mu aimpso pathologies ndi ketoacidosis.

Thimang

Pakati pa mankhwala onse omwe amaperekedwa kwa T2DM, thiazolidinediones ndi abwino kwambiri. Amathandizira kusintha pogawa komanso kutulutsa shuga m'thupi, komanso zimathandizira kuti chiwindi chizichitika. Koma, poyerekeza ndi mankhwala ena, amawononga ndalama zambiri ndikukhala ndi mndandanda wazotsatira zoyipa. Zina mwa izo ndi:

• kulemera mwachangu
• mamvekedwe a mtima
• kutupa
• mafupa olimba
• zilonda zam'mimba.

Masiku ano, mankhwala atsopano otsatirawa kuchokera ku gulu la thiazolidinediones amagwiritsidwa ntchito kwambiri pochiza T2DM:

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

• Aktos. Mapiritsi amagwiritsidwa ntchito ngati monotherapy ya T2DM. Perekerani kuchepa kwamkati popanga shuga mu chiwindi, muteteze mitsempha ya magazi ku kuwonongeka, kusintha kayendedwe ka magazi, kuwongolera kuchuluka kwa shuga m'magazi. Koma ali ndi zovuta zawo - zimathandizira kukulira chilakolako cha chakudya, chifukwa chake akamakamizidwa odwala, zimawonjezeka mofulumira.
• Avandia Imasinthasintha kagayidwe kachakudya mthupi ndipo imakulitsa chidwi cha maselo ku insulin. Ili ndi vuto la hypoglycemic. Ili ndi zotsutsana zambiri komanso zoyipa, zomwe muyenera kuzidziwiratu musanayambe mankhwala.

Alpha Glucosidase Inhibitors

Mwa mankhwala atsopano omwe atengedwa mu T2DM, awa ndi okhawo amtundu wake omwe amatchinga kapangidwe ka enzyme inayake m'matumbo omwe amathandizira kukonza kwa zovuta zamoto. Chifukwa cha izi, kuchuluka kwa mayamwidwe a polysaccharides ndi kuchepa kwa shuga wamagazi kumachepetsedwa.

Zoletsa zotchuka kwambiri za alpha glucosidase mpaka pano ndi:

• Glucobay. Amalandira odwala omwe amakonda kudumpha m'magazi akatha kudya chakudya. Imalekereredwa bwino ndipo siyimakupatsirani kulemera. Glucobai imagwiritsidwa ntchito ngati mankhwala osokoneza bongo ndipo kudya kwake kuyenera kuthandizidwa ndi zakudya zama carb ochepa.
• Miglitol. Amagwiritsidwa ntchito pa matenda a shuga a 2, pamene zakudya komanso zolimbitsa thupi zolimbitsa thupi sizilola kupeza zotsatira zabwino. Mankhwala amatengedwa 1 nthawi patsiku, pamimba yopanda kanthu. Mlingo wake umasankhidwa payekha. Miglitol imakhala ndi ma contraindication ambiri, omwe ali ndi hernias, matenda a m'matumbo, mimba, tsankho kwa magawo, komanso ubwana.

M'zaka zaposachedwa, ma insretins, omwe ali m'gulu la dipeptidyl peptylade inhibitors, ayamba kugwiritsidwa ntchito kwambiri m'chipatala. Amapereka kuchuluka kwa insulin komanso kuchuluka kwa shuga m'magazi. Komabe, sizikhala ndi vuto lililonse pachiwindi ndi impso.

Mwa maretretins, otchuka kwambiri ndi:

• Januvius. Mankhwalawa a T2DM amakhala ndi mphamvu yayitali, choncho amatengedwa nthawi imodzi patsiku. Mlingo umasankhidwa payekha. Mankhwalawa samayambitsa zotsatira zoyipa ndipo amateteza kukula kwa zovuta motsutsana ndi matenda a shuga.
• Galvus. Kubwezeretsanso ma cell a pancreatic ndikuwongolera magwiridwe ake. Mankhwalawa amatengedwa limodzi ndi zakudya komanso kuchita masewera olimbitsa thupi. Ngati sapereka zotsatira zabwino, Galvus imaphatikizidwa ndi mankhwala ochepetsa shuga.

Mankhwala omwe afotokozedwa pamwambapa sangathe kumwa popanda kudziwa dokotala. Kudya kwawo kumapereka chithandizo kwa thupi komanso kupewa kukula kwa matenda ashuga a mtundu woyamba. Koma, ngati munthu satsatira chiwembu chomwe akudya, kumwa, kudya ndi kuchita masewera olimbitsa thupi nthawi zonse, ndiye kuti palibe zomwe angachite.

Ngati mankhwalawa amatengedwa moyenera, koma kuwonjezeka kwadongosolo la shuga m'magazi kupitirira 9 mmol / l, ndi nthawi yoganiza zogwiritsa ntchito mankhwala a insulin.

Limagwirira a zochita za ma impretins

Ma insretins ndi mahomoni amunthu omwe amapangidwa ndi m'mimba thirakiti chakudya chikamalowa. Chifukwa cha zomwe amachita, kupanga insulini kumachulukana, komwe kumathandiza kuti glucose ayamwa, omwe amamasulidwa panthawi yokugaya.

Mpaka pano, mitundu iwiri ya ma insretins yapezeka:

• GLP-1 (glucone-monga peptide-1),
• ISU (insulinotropic polypeptide).

Ma receptor oyamba ali m'magulu osiyanasiyana, zomwe zimamupatsa mwayi wowonetsa bwino. Yachiwiri imayendetsedwa ndi ma pancreatic β-cell receptors.

Mwa zina mwazofunikira zochita:

• kuchuluka katulutsidwe wa mankhwala a insulin ndi ma cell a pancreatic,
• Kuchepetsa m'matumbo,
• kuchepetsa kupezeka kwa glucagon,
• kudya kwakachepera ndi kumva kuti mwakhuta,
• kusintha kwa mtima ndi mitsempha yamagazi, zimathandiza mu ubongo.

Pakuwonjezereka kwa kupanga kwa insulin, shuga amayamba kugwira ntchito bwino, koma ngati zili zabwinobwino, njira yobisalira imasiya ndipo munthuyo sakhala pachiwopsezo cha hypoglycemia. Kutsika kwa kuchuluka kwa glucagon, wotsutsana ndi insulin, kumabweretsa kuchepetsedwa kwa kumwa kwa chiwindi glycogen ndi kumasulidwa kwa shuga wamagulu, pomwe munthawi yomweyo kumathandizira kuwonjezeka kwa kumwa kwa glycogen m'misempha. Zotsatira zake, shuga imagwiritsidwa ntchito nthawi yomweyo pamalo opangira, osalowa m'magazi.

Kutulutsa kwam'mimba kuchepa, chakudya chimalowa m'matumbo m'magawo ang'onoang'ono, omwe amachepetsa kuyamwa kwa magazi m'magazi ndipo, motero, kuchuluka kwake. Kuchita zinthu zing'onozing'ono, kumalowa mosavuta m'thupi. Potere, kuchepa kwa chakudya kumachepetsa kudya kwambiri.

Zowononga dongosolo la kufalikira kwazinthu za pakadali pano zadziwika kale, koma osaphunzira. Zinapezeka kuti ma insretins amathandizira β-cell ya kapamba amachira msanga.

Ndizosatheka kupeza mahomoni mu mawonekedwe awo oyera mokwanira, chifukwa chake asayansi apanga ma analogu omwe amagwira ntchito zofanana:

• kukonzanso zochita za glucone-peptide-1,
• Kuchepetsa mphamvu za ma enzyme owononga, motero kukulitsa moyo wa mahomoni.

Saxagliptin ndi wa gulu lachiwiri.

Kutulutsa Mafomu

Saxagliptin ndi gawo limodzi la mankhwala Onglisa, omwe amagwira ntchito ngati choletsa DPP-4. Chida ichi sichiri pamndandanda wabungwe la chithandizo chamankhwala, koma chingaperekedwe kwa odwala omwe ali ndi matenda osokoneza bongo pakulipiritsa ndalama zakomweko.

Mankhwalawa amapezeka mwa mapiritsi okhala ndi chipolopolo chachikasu, chokhala ndi 2.5 mg ya saxagliptin kapena 5 mg ya hydrochloride yake. Kuphatikizikako kumaphatikizanso magawo omwe amakhathamiritsa mphamvu ya ntchito. Mapiritsiwa alembedwa kuti awonetsetse ake.

Mapiritsi amadzaza paketi yonyamula zidutswa 10 ndi kabokosi.

Zizindikiro ndi contraindication

Kukonzekera kochokera ku Saxagliptin ndikulimbikitsidwa kuti mugwiritse ntchito ndi:

1. Gawo lokhala ndi matenda ashuga, pamene miyambo, kuphatikizapo zakudya, masewera olimbitsa thupi ndi malingaliro ena sizithandiza. Chipangizocho chimakupatsani mwayi wochepetsa kuwonongeka kwa maselo a β-ndipo mukulepheretsa kukula kwa matenda a shuga a 2,
2. Kukhalapo kwa matenda opezeka. Potere, chida chimatha kugwiritsidwa ntchito ngati mankhwala odziimira pawokha kapena kuphatikiza ndi mankhwala ena:
   • Metformin
   • insulin
   • zochokera sulfonylurea,
   • kachikachiyama.

Zotsatira zoyenera kumwa mankhwalawa ndi:

• mtundu 1 shuga
• kutengeka kwambiri ndi chilichonse cha mankhwala,
• chidwi chachikulu kwa DPP-4 zoletsa,
• kukhalapo kwa matenda ashuga a ketoacidosis,
• indigestibility ya lactose ndi kuchepa kwa lactase, kobadwa nako shuga-galactose malabsorption,
• nthawi yodzimbidwa
• zaka zazing'ono.

Milandu iyi, ma fanizo a mankhwalawa amagwiritsidwa ntchito kapena ndalama zomwe zimapangidwa mosiyanasiyana zimasankhidwa.

Kugwiritsa ntchito poyambira mankhwala saxagliptin + metformin

Zotsatira zoyipa ndi bongo

Mankhwalawa alibe zotsatira zoyipa. Ubwino wake waukulu ndikusowa kwa chiopsezo cha hypoglycemia.

Komabe, monga mankhwala aliwonse opangira, zimakhudza kayendedwe kazinthu zathupi, zimathandizira pakusintha kwawo, zomwe zingayambitse:

• chitukuko cha matenda opatsirana a kupuma,
• zovuta zam'mimba,
• sinusitis
• mutu
• gastroenteritis
• kukula kwa kutupa kwamikodzo.

Mukawona zina mwazizindikirozi, muyenera kudandaula kwa asing'anga omwe angasankhe kuchuluka kwa mankhwalawo kapena kuisintha pamapiritsi ena.

Mankhwala osokoneza bongo m'mayesero azachipatala sanawonekere, pomwe zozama za 80 pompopompo kuposa zomwe adalimbikitsa zidagwiritsidwa ntchito. Pankhani ya mankhwala ochulukirapo (mseru, kusanza, kutsegula m'mimba, kupweteka m'mimba, kufooka, ndi zina), mankhwalawa amachitika molingana ndi zizindikiro ndikuchotsedwa kwachangu kwa mankhwala mthupi, zomwe ndizosavuta kudzera mwa hemodialysis.

Akaphatikizidwa ndi mankhwala ena, kutalikirana sikunapezeke. Komabe, kugwiritsa ntchito limodzi ndi metformin ndi thiazolidinediones sikunafufuzidwe.

Kanema kuchokera kwa katswiri: