Mankhwala Baeta: kufotokoza ndi kuwunika

Mankhwala a Baeta ochepetsa shuga m'magazi, exenatide, amadziwika kuti ndi amino acid amidopeptide. Zimakhudza thupi ngati incretin mimetic, imalepheretsa kutsuka kwa m'mimba, ndikuwongolera ntchito ya maselo a beta. Mankhwala, mankhwala ndi mtengo zimasiyanitsa mankhwalawo ndi insulin.

Kwa anthu omwe ali ndi matenda ashuga, kutulutsa Baeta kumathandizira kukhazikitsa kuwongolera kwa glycemic. Izi ndichifukwa cha njira zotsatirazi:

1. Ndi kuchuluka kwa glucose m'magazi, mankhwalawa amayamba kukweza kutulutsa kwa glucose wodalira shuga-kuchokera ku maselo a parenchyma beta.
2. Katulutsidwe amaima pakadali pomwe kuchuluka kwa glucose m'magazi kumayamba kutsika.
3. Mu gawo lotsatira, kuwerengera kwa glucose ndikwabwinobwino.

Odwala omwe ali ndi matenda a shuga a 2, mphindi 10 zoyambirira pambuyo povomerezeka ndi Baeta palibe chinsinsi cha insulin. Exenatide imawonjezereka komanso kubwezeretsanso magawo onse awiri poyankha ya insulin (tikulankhula za matenda a shuga a 2 omwe samatengera insulin).

Ndi matenda matendawa pa nthawi ya exenatide kumachitika:

• kuponderezana kwa katulutsidwe wa glucagon,
• gastric motility imapanikizika,
• kuchepa kwamtima.

Ndi subcutaneous makonzedwe a odwala matenda a shuga mellitus, exenatide amatengeka nthawi yomweyo ndikufika kwake pachimake patatha pafupifupi maola awiri. Theka lomaliza la moyo ndi maola 24, ndipo mlingo wa mankhwalawo sukukhudzanso ndi theka.

Kuchuluka kwa Baeta kumadziwika pambuyo pa maola 10 jekeseni. Mwachilengedwe, muyenera kudziwa momwe mungabayire insulin.

Odwala omwe asokoneza impso, chiwindi ndi okalamba safunika kulowetsa kusintha kwa Bayeta. Kuphatikiza apo, kukhazikitsidwa kwa Exenatide sikutanthauza kuwerengera kwa BMI.

Mankhwala ndi mtundu 2 matenda a shuga kuti awonjezere mankhwala ena ku:

• khalimon
• metformin
• zotengera sulfonylurea,
• kuphatikiza kwa sulfonylurea, metformin ndi zotumphukira,
• kuphatikiza kwa thiazolidinedione ndi metformin,
• kapena pakalibe kuyendetsa bwino glycemic.

Mlingo

Bayeta imaperekedwa mwachangu ku ntchafu, kutsogolo kapena pamimba. Mlingo woyambirira ndi 5 mcg. Lowani 2 kawiri patsiku pafupifupi ola limodzi musanadye chakudya cham'mawa komanso chakudya chamadzulo. Mukatha kudya, mankhwalawa sayenera kuperekedwa.

Ngati wodwala pazifukwa zina adumpha makina a mankhwalawo, majekeseni ena amapezeka osasinthika. Pakatha mwezi umodzi chithandizo, muyeso woyamba wa mankhwalawa uyenera kuchuluka mpaka 10 mcg.

Ndi makonzedwe apakati pa Bayet omwe ali ndi thiazolidinedione, metformin, kapena kuphatikiza kwa mankhwalawa, mlingo woyambirira wa thiazolidinedione kapena metformin sungasinthidwe.

Ngati mungagwiritse ntchito kuphatikiza kwa Baeta ndi zotumphukira za sulfonylurea (kuti muchepetse chiopsezo cha hypoglycemia), mungafunike kuchepetsa mlingo wa zotumphukira za sulfonylurea.

Zolemba ntchito

• Mankhwala sayenera kuperekedwa pambuyo chakudya,
• kuyambitsa kwa mankhwala IM kapena IV osavomerezeka,
• mankhwalawa sayenera kugwiritsidwa ntchito ngati njira yachepetsedwa kapena kwamtambo,
• Bayetu sayenera kuperekedwa ngati tinthu tating'onoting'ono tapezeka mu yankho.
• motsutsana ndi maziko a mankhwala a exenatide, kupanga antibody ndikotheka.

Zofunika! Odwala ambiri omwe thupi lawo limatulutsa ma antibodies otere, titer inachepa ndipo chithandizo chanakhalabe chochepa kwa milungu 82 pomwe chithandizo chimapitilirabe. Komabe, kupezeka kwa antibodies sikumakhudza mitundu ndi pafupipafupi pazotsatira zoyipa zomwe zapezeka.

Dokotala wopezekapo ayenera kudziwitsa wodwala wake kuti kuchiza ndi Bayeta kumapangitsa kuti munthu asakhale ndi chidwi chofuna kudya, komanso thupi. Ichi ndi mtengo wotsika bwino poyerekeza ndi momwe mankhwalawo amathandizira.

Poyeserera koyeserera komwe kunachitika pa makoswe ndi mbewa ndikutulutsa magazi pakhungu ndi jakisoni exenatide, sikunapezeke.

Mlingo wa 128 nthawi yomwe anthu amayesedwa ndi mbewa, makoswe amawonetsa kuchuluka (popanda chiwopsezo chilichonse) cha adenomas a chithokomiro C.

Asayansi amati izi zimachulukitsa nthawi yayitali kwambiri ya nyama yoyesera yolandila exenatide. Pafupipafupi, komabe pakhala kuphwanyidwa kwa impso. Zinaphatikizaponso

• kukula kwa aimpso kulephera,
• kuchuluka seramu creatinine,
• kuchuluka kwa nthawi ya pachimake komanso matenda aimpso kulephera, komwe nthawi zambiri kumafunikira hemodialysis.

Zina mwazowonekera izi zimapezeka mwa odwala omwe amamwa mankhwala amodzi kapena angapo nthawi imodzi omwe amakhudza kagayidwe kamadzi, ntchito yaimpso, kapena kusintha kwina kwa pathological kunachitika.

Mankhwala ophatikizira anali ndi NSAIDs, ACE inhibitors, ndi okodzetsa. Mukamapereka mankhwala othandizira ndikuchotsa mankhwalawo, zomwe mwina zinali zomwe zimayambitsa matenda, minyewa yosinthika ya impso idabwezeretseka.

Pambuyo pochita maphunziro azachipatala komanso a preclinical, exenatide sanawone umboni wa nephrotoxicity yake yachindunji. Poyerekeza ndi momwe agwiritsire ntchito mankhwala a Bayeta, milandu yovuta kwambiri ya kapamba yazindikirika.

Chonde dziwani: Odwala ayenera kudziwa zizindikiro za kapamba kapamba. Mukamapereka mankhwala othandizira, kuchiritsa kwachimbudzi kumachitika.

Asanapitilize ndi jekeseni la Bayeta, wodwalayo awerenge malangizo omwe aphatikizidwa ogwiritsa ntchito cholembera, mtengo umasonyezedwanso pamenepo.

Contraindication

1. Kupezeka kwa matenda ashuga ketoacidosis.
2. Mtundu woyamba wa shuga.
3. Mimba
4. Kupezeka kwa matenda am'mimba kwambiri.
5. Kulephera kwakukulu kwaimpso.
6. Kuyamwitsa.
7. Zaka mpaka 18.
8. Hypersensitivity pamagawo a mankhwala.

Mimba komanso Kuyamwitsa

M'magawo onse awiriwa, mankhwala amatsutsana. Mtengo wa malingaliro achinyengo pazolimbikitsazi ukhoza kukhala wokwera kwambiri. Amadziwika kuti zinthu zambiri zamankhwala zimakhumudwitsa kukula kwa mwana wosabadwayo.

Mayi wonyalanyazidwa kapena wopanda nzeru amatsogolera kubadwa kwa mwana wosabadwa. Pafupifupi mankhwala onse amalowa mthupi la mwana ndi mkaka wa amayi, motero magulu awa odwala ayenera kusamala ndi mankhwalawa.

Monotherapy

Zotsatira zoyipa zomwe zimawonedwa mwa odwala koposa kamodzi zidalembedwa motere:

Zomwe zimachitika:

• Kuyabwa nthawi zambiri kumachitika m'malo a jakisoni.
• Pafupipafupi, redness ndi zotupa.

Pa gawo la dongosolo logaya chakudya, mawonetsedwe otsatirawa nthawi zambiri amapezeka:

Mitsempha yapakati ya m'magazi nthawi zambiri imakumana ndi chizungulire. Ngati tiyerekeza mankhwala a Bayeta ndi placebo, ndiye kuti kuchuluka kwa zochitika za hypoglycemia pamankhwala omwe afotokozedwawo kumakhala kwakukulu ndi 4%. Kukula kwa ma episode a hypoglycemia amadziwika ngati ofatsa kapena odziletsa.

Kuphatikiza mankhwala

Zochitika zoyipa zomwe zimawonedwa kwa odwala kopitilira kamodzi ndi chithandizo cha mankhwala ophatikizika ndizofanana ndi omwe ali ndi monotherapy (onani tebulo pamwambapa).

Dongosolo la chimbudzi limayankha:

1. Nthawi zambiri: kusowa kwa chakudya, nseru, kusanza, kutsegula m'mimba, gastroesophageal Reflux, dyspepsia.
2. Nthawi zambiri: kumatulutsa ndi kupweteka kwam'mimba, kudzimbidwa, kuyereketsa, kuphwanya, kusweka kwa zotengeka zamkati.
3. Nthawi zambiri: pachimake kapamba.

Nthawi zambiri, kunyansidwa kwamphamvu kapena kufooka mwamphamvu kumawonedwa. Imadalira mlingo ndipo imatsika pakapita nthawi popanda kukhudza zochita za tsiku ndi tsiku.

Mitsempha yapakati ya m'magazi nthawi zambiri imakumana ndi mutu komanso chizungulire, kawirikawiri ndi kugona.

Kumbali ya endocrine system, hypoglycemia imawonedwa kwambiri ngati exenatide ikuphatikizidwa ndi zotumphukira za sulfonylurea. Kutengera izi, ndikofunikira kuwunika kuchuluka kwa zotumphukira za sulfonylurea ndikuwachepetsa ndi chiwopsezo cha hypoglycemia.

Mitundu yambiri ya hypoglycemic mu kukula imadziwika kuti ndi yofatsa komanso yodziletsa. Mutha kusiya izi pokhapokha pogwiritsa ntchito chakudya. Kumbali ya kagayidwe, mukamamwa mankhwala a Bayeta, Hyperhidrosis imatha kuonedwa, nthawi zambiri kusowa kwamadzi komwe kumachitika chifukwa cha kusanza kapena kutsegula m'mimba.

Kwamikodzo dongosolo kawirikawiri amakumana ndi pachimake aimpso kulephera komanso zovuta matenda.

Ndemanga zikuwonetsa kuti thupi siligwirizana kwenikweni. Izi zitha kukhala zowonetsera edema kapena anaphylactic.

Zomwe zimachitika pakadutsa jakisoni wa exenatide zimaphatikizapo zotupa, redness, ndi kuyabwa pamalowo jakisoni.

Pali malingaliro a milandu ya kuchuluka kwa erythrocyte sedimentation rate (ESR). Izi ndizotheka ngati escinate idagwiritsidwa ntchito nthawi yomweyo ndi warfarin. Mawonetseredwe oterewa nthawi zina amatha kutsagana ndi magazi.

Kwenikweni, zotsatirapo zake zinali zochepa kapena zolimbitsa thupi, zomwe sizinafune kusiya chithandizo.

Ndemanga zokha komanso mtengo wake

Kuchokera kumbali ya chapakati mantha dongosolo: kugona, dysgeusia.

Matenda a Metabolic ndi zakudya: kawirikawiri kwambiri - kuwonda kumagwirizanitsidwa ndi mseru kapena matenda am'mimba.

Ndemanga zikuwonetsa kuti mawonekedwe a anaphylactic ndi osowa kwambiri.

Kuchokera mmimba dongosolo: flatulence, kudzimbidwa, kawirikawiri - pachimake kapamba.

Kuchokera kwamikodzo dongosolo: kusintha kwa impso, kuchuluka kwa ndende, kulephera kwa impso, kukokomeza kwa kulephera kosalekeza.

Dermatological zimachitika: khungu kuyabwa, alopecia, maculopapular zidzolo, angioedema, urticaria.

Mtengo wa mankhwalawo m'masitolo a likulu limayambira 2500r pa phukusi lililonse.