Mndandanda wa mankhwala Victoza

Liraglutide ndi amodzi mwa mankhwala atsopano omwe amachepetsa kwambiri shuga m'magazi omwe ali ndi matenda a shuga. Mankhwalawa ali ndi mphamvu zambiri: amathandizira kupanga insulin, amalepheretsa kuphatikizika kwa glucagon, amachepetsa chilimbikitso, ndipo amachepetsa kuyamwa kwa shuga m'mazakudya.

Zaka zingapo zapitazo, Liraglutide idavomerezedwa ngati njira yochepetsera kulemera kwa odwala omwe alibe shuga, koma kunenepa kwambiri. Ndemanga za iwo omwe akuchepetsa thupi akuwonetsa kuti mankhwalawa atha kukwaniritsa zotsatira zabwino kwa anthu omwe ataya kale chiyembekezo cha kulemera kwabwino. Polankhula za Liraglutida, munthu sangathe kulephera kutchula zolakwika zake: mtengo wokwera kwambiri, kulephera kutenga mapiritsiwo mwanjira yanthawi zonse, kudziwa kosakwanira kogwiritsa ntchito.

Mawonekedwe ndi kapangidwe ka mankhwala

M'matumbo athu, mahomoni amtundu wa impretin amapangidwa, pomwe ma glucagon-ngati peptide GLP-1 amatenga gawo lalikulu pakuwonetsetsa kuti shuga ali ndi shuga. Liraglutide ndi analogue yopanga yopanga ya GLP-1. Kuphatikizika ndi kutsatana kwa ma amino acid mu molekyulu ya Lyraglutide akubwereza 97% ya peptide yachilengedwe.

Chifukwa cha kufanana uku, pakulowa m'magazi, chinthucho chimayamba kugwira ntchito ngati maholide achilengedwe: poyankha kuchuluka kwa shuga, imalepheretsa kutulutsa shuga ndikuyambitsa kuphatikizika kwa insulin. Ngati shuga ndiwabwinobwino, zochita za liraglutide zimayimitsidwa, motero, hypoglycemia siziwopseza odwala matenda ashuga. Zowonjezera za mankhwalawa zimalepheretsa kupanga kwa hydrochloric acid, kufooketsa mphamvu yam'mimba, kuponderezana ndi njala. Mphamvu imeneyi ya liraglutide pamimba ndi mphamvu yamanjenje imalola kuti igwiritsidwe ntchito pochotsa kunenepa kwambiri.

Natural GLP-1 imasweka mwachangu. Pakangotha ​​mphindi ziwiri zitatuluka, theka la peptide limatsalira m'magazi. Artificial GLP-1 ili m'thupi motalika, osachepera tsiku.

Liraglutide silingatengedwe pakamwa ngati mawonekedwe a mapiritsi, popeza m'matumbo amataya ntchito. Chifukwa chake, mankhwalawa amapezeka mu mawonekedwe a yankho ndi yogwira mtima ya 6 mg / ml. Kuti mugwiritse ntchito mosavuta, ma cartridge a solution amayikidwa mu zolembera. Ndi chithandizo chawo, mutha kusankha mlingo woyenera ndikupanga jakisoni m'malo osayenera izi.

Zizindikiro

Liraglutid idapangidwa ndi kampani yaku Danish NovoNordisk. Pansi pa malonda a Victoza, agulitsidwa ku Europe ndi USA kuyambira 2009, ku Russia kuyambira 2010. Mu 2015, Liraglutide idavomerezeka ngati mankhwala ochizira kunenepa kwambiri. Mlingo woyenera wochepetsa thupi ndiwosiyana, motero chida chinayamba kumasulidwa ndi wopanga pansi pa dzina lina - Saxenda. Viktoza ndi Saksenda ndi mitundu yosinthasintha; Zomwe zimapangidwira zimafanananso: sodium hydrogen phosphate, propylene glycol, phenol.

Mu phukusi la mankhwala 2 syringe zolembera, aliyense 18 mg wa liraglutide. Odwala odwala matenda ashuga amalangizidwa kuti azigwiritsa ntchito kuposa 1.8 mg patsiku. Mlingo wamba wolipirira matenda a shuga kwa odwala ambiri ndi 1.2 mg. Ngati mutamwa mankhwalawa, paketi ya Victoza ndi yokwanira mwezi umodzi. Mtengo wa ma CD ndi ma ruble 9500.

Kuti muchepetse kunenepa, mulingo wambiri wa liraglutide ndi wofunikira kuposa shuga wamba. Kwambiri, maphunzirowa amalimbikitsa kumwa 3 mg ya mankhwala patsiku. Mu phukusi la Saksenda muli zolembera 5 za 18 mg zamagulu othandizira mumtundu uliwonse, 90 mg ya Liragludide - ndendende maphunziro a mwezi. Mtengo wapakati mumasitolo amakankhwala ndi ma ruble 25,700. Mtengo wa chithandizo ndi Saksenda ndiwokwera pang'ono kuposa mzake: 1 mg ya Lyraglutide ku Saksend imawononga ma ruble 286, ku Viktoz - 264 rubles.

Kodi Liraglutide amagwira ntchito bwanji?

Matenda a shuga amadziwika ndi polymorbidity. Izi zikutanthauza kuti aliyense wodwala matenda ashuga ali ndi matenda angapo omwe ali ndi vuto limodzi - matenda a metabolic. Odwala nthawi zambiri amapezeka kuti ali ndi matenda oopsa, atherosulinosis, matenda a mahomoni, odwala oposa 80% ndi onenepa kwambiri. Ndi kuchuluka kwa insulini, kuchepa thupi kumakhala kovuta kwambiri chifukwa chokhala ndi njala nthawi zonse. Anthu odwala matenda ashuga amafunikira chakudya champhamvu kuti atsate zakudya zamafuta ochepa. Liraglutide amathandizira osati kuchepetsa shuga, komanso kuthana ndi kulakalaka kwa maswiti.

Zotsatira za kumwa mankhwalawa malinga ndi kafukufuku:

1. Kutsika kwapakati pa hemoglobin wa glycated mu odwala matenda ashuga otenga 1.2 mg wa Lyraglutide patsiku ndi 1.5%. Mwa ichi, mankhwalawa ndi abwino osati amachokera ku sulfonylurea, komanso sitagliptin (mapiritsi a Januvia). Kugwiritsa ntchito liraglutide kokha komwe kumatha kulipirira shuga mu 56% ya odwala. Kuphatikizidwa kwa mapiritsi a kukana insulin (Metformin) kumawonjezera mphamvu ya mankhwalawa.
2. Kusala shuga kumatsika kuposa 2 mmol / L.
3. Mankhwala amalimbikitsa kuchepa thupi. Patatha chaka cholamulira, kulemera kwa odwala 60% kumachepera kuposa 5%, mu 31% - ndi 10%. Ngati odwala amatsatira zakudya, kuchepa thupi kwambiri. Kuchepetsa thupi kumapangidwira makamaka kuchepetsa kuchuluka kwamafuta a visceral, zotsatira zabwino zimawonedwa m'chiuno.
4. Liraglutide amachepetsa kukana insulini, chifukwa choti glucose amayamba kusiya ziwiya mwachangu, kufunika kwa insulini kumachepa.
5. Mankhwalawa amachititsa kuti pakhale masisitere a hypothalamus, potero amachepetsa kumverera kwanjala. Chifukwa cha izi, zopatsa mphamvu za tsiku ndi tsiku za chakudya zimatsika zokha pafupifupi 200 kcal.
6. Liraglutide amakhudza pang'ono kupanikizika: pafupifupi, amachepetsa ndi 2-6 mm Hg. Asayansi amati izi zimapangitsa kuti mankhwalawa akhale othandizira pa makhoma a mitsempha yamagazi.
7. Mankhwalawa ali ndi katundu wa mtima, amakhala ndi zotsatira zabwino zama lipids zamagazi, kutsitsa cholesterol ndi triglycerides.

Malinga ndi madokotala, Liraglutid ndiwothandiza kwambiri poyambira matenda ashuga. Kuika koyenera: Wodwala yemwe amamwa mapiritsi a Metformin pamtengo wokwanira, kukhala ndi moyo wakhama, kutsatira zakudya. Ngati matendawa sakulipiridwa, sulfonylurea mwachikhalidwe imawonjezeredwa ku njira yolandirira, yomwe mosakayikira imayambitsa kukula kwa matenda ashuga. Kusintha mapiritsiwo ndi Liraglutide kumakupatsani mwayi wopewa zotsatira zoyipa maselo a beta, kuti mupewe kuvala koyamba kwa kapamba. Maphatikizidwe a insulin samachepa pakapita nthawi, mphamvu ya mankhwalawa imakhala yosasintha, kuwonjezereka kwa mankhwalawa sikofunikira.

Mukasankhidwa

Malinga ndi malangizo, Liraglutid adalembedwa kuti athetse ntchito zotsatirazi:

• kulipira shuga. Mankhwala atha kumwa mankhwalawa pamodzi ndi mapiritsi a insulin ndi hypoglycemic kuchokera m'magulu a biguanides, glitazones, sulfonylureas. Malinga ndi malingaliro apadziko lonse lapansi, Ligalutid wa matenda a shuga amagwiritsidwa ntchito ngati mankhwala a mizere iwiri. Maudindo oyamba akupitilizidwa ndi mapiritsi a Metformin. Liraglutide monga mankhwala okhawo amangokhazikitsidwa ndi kusalolera kwa Metformin. Chithandizo chimathandizidwa ndi masewera olimbitsa thupi komanso zakudya zamafuta ochepa,
• kuchepetsa chiopsezo cha kugwidwa ndi matenda a mtima ndi odwala matenda ashuga. Liraglutide imatchulidwa ngati njira yowonjezera, ikhoza kuphatikizidwa ndi ma statins,
• kukonza kunenepa kwambiri kwa odwala omwe alibe shuga ndi BMI pamwambapa 30,
• chifukwa cha kuchepa thupi kwa odwala omwe ali ndi BMI pamwambapa 27, ngati atapezeka ndi matenda amodzi omwe amapezeka ndi matenda a metabolic.

Zotsatira za liraglutide pa kulemera zimasiyana kwambiri mwa odwala. Poyerekeza ndi kuyesa kunenepa, ena amataya ma kilogalamu, pomwe ena amakhala ndi zotsatira zochepa, mkati mwa 5 kg. Onaninso momwe Saksenda adatengedwera kutengera zotsatira za chithandizo cha miyezi 4. Ngati pofika nthawi yochepera 4% ya kulemera kwenikweni kwa thupi, kuchepa thupi mwa wodwala sikuwoneka kuti kungachitike, mankhwalawa amayimitsidwa.

Ziwerengero za anthu ochepera thupi malinga ndi zotsatira za mayeso apachaka zimaperekedwa mu malangizo ogwiritsira ntchito Saksenda:

Popeza kuti jakisoni ndi ndalama zingati, mankhwalawa amayamba kuchepa thupi. Lyraglutidu ndi zotsatira zake zoyipa zamagetsi m'mimba sizimawonjezera kutchuka.

Pharmacodynamics ndi pharmacokinetics

Mankhwala

Ndi analog glucagon-ngati peptide-1 munthu yemwe amapangidwa ndi biotechnology ndipo amafanana 97% ndi umunthu. Amamangirira ku GLP-1 receptors, omwe ndiwo chandamale cha mahomoni opangidwa m'thupi incretin.

Zotsalazo zimalimbikitsa kupanga insulin poyankha kuchuluka kwa shuga m'magazi.
Nthawi yomweyo, ntchito yogwira mankhwala imalepheretsa kupanga shuga. Ndipo, Tikawonetsetsa hypoglycemiaamachepetsa kubisika kwa insulin, ndipo sikukhudza katulutsidwe wa glucagon. Amachepetsa kulemera komanso amachepetsa mafuta, kuchepetsa nkhawa.

Maphunziro a nyama ndi prediabeteskuloledwa kunena kuti liraglutide imachedwetsa kukula kwa matenda ashuga, imathandizira kuwonjezeka kwa maselo a beta. Zochita zake zimatha maola 24.

Pharmacokinetics

Mankhwalawa amamwetsedwera pang'onopang'ono, ndipo pokhapokha ngati maola 8-12 ndi omwe amapezeka kwambiri m'magazi. Bioavailability ndi 55%. 98% omangidwa m'mapuloteni a magazi. Pakupita maola 24, liraglutide sasintha mthupi. T1 / 2 ndi maola 13. Ma metabolites ake atatu amachotsedwa pakatha masiku 6- 6 atabayidwa.

Zizindikiro zogwiritsidwa ntchito

Victoza amagwiritsidwa ntchito ngati mtundu 2 wa shuga ngati:

• monotherapy
• kuphatikiza mankhwala ndi m`kamwa hypoglycemic mankhwala - Glibenclamide, Dibetolong, Metformin,
• kuphatikiza mankhwala ndi insulinNgati mankhwala ophatikiza kale mankhwala sanali ogwira.

Kuchiza muzochitika zonse kumachitika motsutsana ndi maziko azakudya ndi masewera olimbitsa thupi.

Contraindication

• mtundu 1 shuga,
• Hypersensitivity mankhwala
• mimbandi kuyamwitsa,
• ketoacidosis,
• kulephera kwamtima kwambiri,
• colitis,
• wazaka 18
• paresis am'mimba.

Zotsatira zoyipa

Zambiri zoyipa zimakhudzana mwachindunji ndi kapangidwe kamankhwala. Chifukwa chakuchepa kwa chimbudzi cha chakudya m'milungu yoyamba ya mankhwala ndi Liraglutide, zotsatira zoyipa za m'mimba zimawonekera: kudzimbidwa, kutsegula m'mimba, kupangika kwa mpweya, kupweteka, kupweteka chifukwa cha kuphuka. Malinga ndi ndemanga, kotala la odwala amamva mseru wosiyanasiyana. Kukhala ndi moyo wabwino kumakhala bwino pakapita nthawi. Pambuyo pa miyezi isanu ndi umodzi ya kudya pafupipafupi, 2% yokha ya odwala amadandaula ndi mseru.

Kuchepetsa zotsatirazi, thupi limapatsidwa nthawi yoti lizolowere Liraglutid: chithandizo chimayamba ndi 0,6 mg, mlingo umakulitsidwa pang'ono ndi pang'ono. Khansa ya m'mimba siyimakhudza chikhalidwe cha ziwalo zolimbitsa thupi. Mu zotupa matenda am'mimba thirakiti, kukhazikitsa liraglutide ndi koletsedwa.

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

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

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

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

Zotsatira zoyipa za mankhwala zomwe zapezeka mu malangizo:

Odwala omwe ali ndi matenda a chithokomiro, zotsatira zoyipa za mankhwalawa zimadziwika. Tsopano Liraglutid akupitilizabe mayeso ena kupatula kulumikizana kwa kumwa mankhwalawa ndi khansa ya chithokomiro. Mwayi wogwiritsa ntchito liraglutide mwa ana ukuphunziridwanso.

Sabata yoyamba ya liraglutide imayendetsedwa pa mlingo wa 0,6 mg. Ngati mankhwalawa alekeredwa bwino, patatha sabata limodzi mlingo umawonjezeredwa. Zotsatira zoyipa zikagwera, amapitilirabe jakisoni wa 0.6 mg kanthawi mpaka amve bwino.

Mlingo wowonjezeredwa pamlingo wowonjezera ndi 0,6 mg pa sabata. Mu shuga mellitus, mulingo woyenera kwambiri ndi 1,2 mg, upamwamba - 1,8 mg. Mukamagwiritsa ntchito Liraglutide kuchokera kunenepa kwambiri, mlingo umasinthidwa kukhala 3 mg mkati mwa masabata 5. Kuchuluka izi, Lyraglutide amawayamwa miyezi 4-12.

Momwe mungapangire jakisoni

Malinga ndi malangizowo, jakisoni amapangidwa mosinjirira m'mimba, mbali yakunja ya ntchafu, ndi mkono wam'mwamba. Malowo a jakisoni amatha kusinthidwa popanda kuchepetsa mphamvu ya mankhwalawo. Lyraglutide ndi jekeseni nthawi yomweyo. Ngati nthawi yoyendetsayo yasowa, jakisoni ikhoza kuchitika mkati mwa maola 12. Ngati zambiri zadutsa, jakisoniyu wadumpha.

Liraglutide ili ndi cholembera, chosavuta kugwiritsa ntchito. Mlingo wofunikira ukhoza kuyikidwa pa dispenser.

Momwe mungapangire jakisoni:

• chotsani filimu yoteteza ku singano,
• chotsani kachipewa m'manja,
• ikani singano pachikhathocho potembenuza mosakhalitsa
• chotsani kansalu ndi singano,
• tembenuza gudumu (mutha kuloza mbali zonse) za kusankha kwa mankhwalawo kumapeto kwa chogwirira mpaka malo omwe mukufunako (mulingo womwewo udzawonetsedwa pazenera),
• ikani singano pansi pakhungu, cholembera ndi chowongoka,
• kanikizani batani ndikuyigwira mpaka itawonekera pazenera,
• chotsani singano.

Mndandanda wa mankhwala omwe ali ndi Victoza

NovoNorm (mapiritsi) → M'malo olowa m'malo: 11 Up

Analogue ndiyotsika mtengo kuchokera ku ma ruble 9130.

NovoNorm imapangidwa ku Denmark m'mapiritsi a 1 ndi 2 mg (No. 30). Mankhwalawa amachepetsa shuga m'magazi potseka njira zotsalira za ATP m'maselo a beta, kapangidwe kake ka insulin. Kuphatikiza apo, mankhwalawa amatha kuchepetsa kulemera kwa odwala omwe ali ndi matenda a shuga a 2. Amagwiritsidwa ntchito ngati mtundu wa shuga wachiwiri kukhala ndi shuga wamagazi komanso milingo ya hemoglobin. Amagwiritsidwa ntchito limodzi ndi matenda a shuga a 2 komanso kunenepa kwambiri kuti azilamulira kuchuluka kwa shuga komanso kuchepetsa thupi. Ngati ndi kotheka, mutha kuphatikiza ndimankhwala ena a hypoglycemic ndi insulin. Mlingo wa mankhwala umasankhidwa payekha kwa wodwala aliyense. Monga lamulo, mankhwalawa amayamba ndi mlingo wa 500 mcg. Zitha kuchititsa kuchepa kwa shuga m'magazi, omwe amadziwonetsera pakhungu. Kukhalapo kwa kuzizira, thukuta lomata, palpitations, chizungulire, ndipo pamakhala kusokonezeka kwa chikumbumtima, kuphatikizapo chikomokere ndi matenda opweteka. Thupi lawo siligwirizana, zochitika zoyipa kuchokera m'matumbo am'mimba, komanso kukula kwa aimpso komanso kwa hepatic ndikwananso. Contraindified mu idiosyncrasy, mtundu 1 shuga, kusokonezeka kwa chikumbumtima, chiwindi chachikulu ndi impso matenda, pakati ndi mkaka wa m`mawere.

Analogue ndiotsika mtengo kuchokera ku ma ruble 9071.

Jardins ndi analogue yaku Germany ya Victoza, yomwe imapezeka pamapiritsi a 10 ndi 25 mg (No. 30).Mankhwala amalepheretsa kusintha kwa glucose wa mtundu wachiwiri, kumachepetsa kuyamwa kwa glucose mu impso ndikuthandizira kuphipha kwake, kutsitsa kuchuluka kwa shuga m'magazi. Kuphatikiza apo, mankhwalawa amachepetsa index ya umzimba mwa odwala omwe ali ndi matenda a shuga a 2. Amagwiritsidwa ntchito kwa odwala omwe ali ndi matenda a shuga a 2 komanso kudya kwambiri mapuloteni komanso kuchita masewera olimbitsa thupi kuti azitha kukhala ndi shuga wamagazi ambiri, kuphatikizapo kusakwanira komanso kusalolera kwa metformin. Mothandizidwa amachepetsa kulemera kwamthupi mwa odwala omwe amaphatikiza matenda a shuga a 2 komanso kunenepa kwambiri. Itha kugwiritsidwa ntchito limodzi ndi metformin ndi insulin. Zitha kupangitsa kuti hypoglycemia, kuphatikizapo chikomokere, chizungulire, kufooka, mutu, kukula kwa mabakiteriya komanso matenda oyamba ndi mafinya, nseru, kusanza, kupweteka ndi m'mimba, kusokonekera kwa chimbudzi, kuwonongeka kwa chiwindi ndi impso, kuchepa kuchuluka kozungulira magazi. Amatsutsana ndi matenda amtundu wa 1 shuga, kusalolera, matenda a impso, kuwonongeka kwa matenda a shuga, kusokonezeka kwa chikumbumtima, kuchepa kwa lactase, ana ndi anthu azaka zopitilira 85, azimayi omwe ali ndi bere komanso kuyamwitsa.

Invokana (mapiritsi) → cholowa M'malo: 2 Up

Analogue ndiotsika mtengo kuchokera ku ma ruble a 6852.

Invocana (analogue) - imapangidwa ku Puerto Rico, Russia ndi Italy m'mapiritsi a 100 mg (No. 30). Mankhwalawa amalepheretsa mpweya wonyamula sodium-glucose wamtundu wachiwiri, amathandizanso kuyamwa kwa glucose m'm impso ndikuwonjezera mphamvu yake pochotsa mkodzo, kuchepetsa kuchepa kwa magazi. Mankhwalawa amathandizanso kuchepetsa thupi kwa odwala omwe ali ndi matenda a shuga a 2. Amawonetsedwa kuti agwiritsidwe ntchito kwa odwala omwe ali ndi mtundu wachiwiri wa shuga wambiri monga monotherapy komanso kuphatikiza mankhwala ena otsitsa shuga. Amamwa mankhwalawa kamodzi patsiku (m'mawa) kuyambira pa 100 mg. Zitha kuyambitsa zotupa pakhungu ndi kuyabwa, angioedema, anaphylactic mantha, nseru, kusanza, kudzimbidwa, kupweteka kwam'mimba, kupweteka pafupipafupi kukhetsa, hypoglycemia mpaka chikomokere, ludzu, kulephera kwa impso, kukula kwa mabakiteriya ndi matenda oyamba ndi mafangasi, kuchepa magazi mozungulira, kukomoka, . Sitha kugwiritsidwa ntchito ngati idiosyncrasy, mtundu 1 shuga, aimpso kwambiri komanso kuperewera kwa hepatic, chifukwa cha ketoacidosis, azimayi omwe amabereka ana ndikuyamwitsa, ana ndi achinyamata osakwana zaka 18.

Bayeta (yankho la sc management) → M'malo mwaulemu: 15 Pamwamba

Analogue ndiyotsika mtengo kuchokera ku ma ruble 4335.

Wopanga: ASTRAZENECA UK Limited (Great Britain)
Kutulutsa Mafomu:

• Yankho la subcutaneous makonzedwe, 250 mcg / ml 1.2 ml, No. 1

Baeta - analogue ya Victoza, imapangidwa ku UK, USA ndi Russia mu zolembera za syringe ya 1.2 kapena 2.4 ml. Zomwe zimagwira ndi exenatide. Mankhwalawa amagwira pama receptor a glucagon ngati peptide-1, amachititsa kuchuluka kwa insulin komanso kuletsa kutulutsa kwa glucagon, kuchepa kwa shuga m'magazi, kumachepetsa chilimbikitso, kupondereza kuthamanga kwa m'mimba ndi m'mimba, ndikuchepetsa mphamvu ya m'mimba ndi matumbo, ndikuchepetsa thupi. Monga monotherapy yophatikiza ndi zakudya komanso zolimbitsa thupi zolimbitsa thupi zimagwiritsidwa ntchito mwa odwala omwe ali ndi mtundu wa 2 shuga mellitus kuti azitha kuchepetsa kuchuluka kwa glucose komanso kuchepetsa thupi. Mankhwala ophatikizidwa amagwiritsidwa ntchito ngati mtundu wachiwiri wa matenda ashuga osakwanira metformin ndi mankhwala omwe amapezeka ndi sulfanylureas kuwonjezera pa iwo. Mankhwala kutumikiridwa subcutaneous kawiri pa tsiku, kuyambira limodzi mlingo 5 mg. Zitha kupangitsa kuti magazi achepetse, kusokonezeka kwakanthawi, matenda oopsa, kupweteka mutu, chizungulire, hypoglycemia, kuchepa thupi, kuchepa kwa chakudya, kugona, komanso kusowa kwa pancreatic. Imaphatikizidwa chifukwa cha tsankho, matenda a shuga 1, matenda am impso, matumbo am'mimba, kapamba yam'mimba, azimayi pakukonzekera ndi kuyamwitsa, kuubwana ndi unyamata.

Trulicity (yankho la sc management) → cholowa m'malo: 16 Pamwamba

Analogue ndiokwera mtengo kwambiri kuchokera ma ruble 3655.

Trulicity - analogue ya Victoza, imapezeka ku Switzerland, USA ndi Russia m'njira yankho la subcutaneous jakisoni mu 0,5 ml syringe pens (No. 4). Mankhwalawa, limodzi ndi victoza, ndi ochita masewera olimbitsa thupi a GLP-1. Mankhwalawa amathandizira kuchuluka kwa insulin komanso kutsitsa glucagon, zomwe zimapangitsa kutsika kwa shuga. Kuphatikiza apo, mankhwalawa ali ndi anorexigenic zotsatira ndipo amachepetsa kuthamanga kwa magazi. Amagwiritsa ntchito mankhwalawa mtundu wa 2 matenda a shuga limodzi ndi chithandizo chamankhwala komanso zolimbitsa thupi. Ndiwothandiza kwambiri kwa odwala omwe amapezeka ndi matenda amtundu wa 2 komanso kunenepa kwambiri. Gawani, makamaka ndi kusakhazikika kwa mankhwala ena ochepetsa shuga komanso komanso kuleza mtima kwawo. Itha kugwiritsidwa ntchito limodzi ndi othandizira okhala ndi hypoglycemic ndi insulin. Zotsatira zoyipa kwambiri komanso zoopsa ndi hypoglycemia. Zomwe zimachitika kawirikawiri ndipo thupi limatulutsa, mseru, kusanza, kupweteka, kufinya, kupindika, kukomoka mkamwa, kuchepa kwa mtima, phokoso la mtima ndi kusokonezeka kwa mtima. Contraindicated vuto la tsankho, mtundu woyamba wa matenda a shuga, matenda a chiwindi, impso, mtima, m'mimba thirakiti, ketoacidosis, ana, akazi akubala mwana ndi kuyamwitsa.

Kufotokozera za mankhwalawa

Liraglutide * (Liraglutide *) - Wothandizira Hypoglycemic. Liraglutide ndi analogue ya glucagon yofanana ndi peptide-1 (GLP-1), yopangidwa ndi recombinant DNA biotechnology pogwiritsa ntchito Saccharomyces cerevisiae strain, yomwe ili ndi 97% ya Homology ya anthu ndi GLP-1, yomwe imamanga ndikuyambitsa zolandirira za GLP-1 mwa anthu. Receptor ya GLP-1 imagwira ntchito ngati chandamale cha mbadwa za GLP-1, ma endreteni am'mimba amkati, omwe amathandizira secretion ya shuga ya glucose omwe amadalira maselo a pancreatic beta. Mosiyana ndi mbadwa ya GLP-1, ma pharmacokinetic ndi ma pharmacodynamic Mbiri ya liraglutide amalola kuti ziziperekedwa kwa odwala tsiku lililonse 1 nthawi / tsiku.

Mbiri yayitali ya liraglutide pakubaya kwapansipansi imaperekedwa ndi njira zitatu: kudziphatikiza, komwe kumapangitsa kuti mankhwalawa achedwe, kumangiriza ku albumin komanso kuchuluka kwakukulu kwa enzymatic pokhudzana ndi dipeptidyl peptidase-4 (DPP-4) ndi ndale endopeptidase enzyme (NEP) , chifukwa chomwe moyo wautali wa mankhwalawo umatheka. Kuchita kwa liraglutide kumachitika chifukwa cha kulumikizana ndi ma receptors ena a GLP-1, chifukwa chomwe kuchuluka kwa cyclic cAMP adenosine monophosphate kumakwera. Mothandizidwa ndi liraglutide, kukhudzana ndi shuga kwa insulin katulutsidwe kumachitika. Nthawi yomweyo, liraglutide imapumira shuga wambiri wodalira shuga. Chifukwa chake, ndi kuchuluka kwa kuchuluka kwa shuga m'magazi, insulin katulutsidwe imakhudzidwa ndipo katulutsidwe wa glucagon amakakamizidwa. Komabe, pa hypoglycemia, liraglutide amachepetsa katemera wa insulin, koma sayimitsa katulutsidwe wa glucagon. Njira yochepetsera glycemia imaphatikizanso kuchepetsedwa pang'ono kwa madzi am'mimba. Liraglutide amachepetsa thupi komanso amachepetsa mafuta m'thupi pogwiritsa ntchito zida zomwe zimapangitsa kuchepa kwa njala komanso kugwiritsa ntchito mphamvu zochepa.

Liraglutide ali ndi nthawi yayitali ya maola 24 ndipo amakonzanso kayendedwe ka glycemic pochepetsa kuchuluka kwa shuga m'magazi ndikatha kudya odwala omwe ali ndi matenda a shuga a 2.

Ndi kuwonjezeka kwa ndende ya magazi, liraglutide imawonjezera katemera wa insulin. Mukamagwiritsa ntchito shuga wa kulowetsedwa kwa shuga, kutsekeka kwa insulini pambuyo pa kumwa kamodzi kwa liraglutide kwa odwala omwe ali ndi matenda a shuga 2 kumawonjezera pamlingo wofanana ndi omwe amakhala ndi maphunziro abwino.

Liraglutide kuphatikiza mankhwala ophatikizika ndi metformin, glimepiride, kapena kuphatikiza kwa metformin ndi rosiglitazone kwa masabata 26 kunapangitsa kuchuluka kwakukulu (p 1c poyerekeza ndi chidziwitso chomwecho mwa odwala omwe analandira chithandizo cha placebo.

Ndi liraglutide monotherapy, kuchuluka kwakukulu kwakanawonedwa kwa masabata 52 (p 1c poyerekeza ndi chisonyezo chomwecho mwa odwala omwe amathandizidwa ndi glimepiride. Komabe, kuchepa kwakukulu kwa HbA 1c pansipa 7% kunapitirira kwa miyezi 12. Chiwerengero cha odwala omwe amafikira HbA 1c 1c ≤6.5%, yowerengeka kwambiri (p≤0.0001) inachuluka mokhudzana ndi kuchuluka kwa odwala omwe amalandira chithandizo chokhacho, popanda kuwonjezera kwa liraglutide, omwe ali ndi mankhwala a hypoglycemic, pomwe kunali kotheka kukwaniritsa mulingo wa HbA wa 1c TH malo a mankhwala liraglutide * (liraglut>

Analogs a Liraglutida

Chitetezo cha Patent cha Liraglutide chimatha mu 2022, mpaka nthawi iyi sikoyenera kuyembekezera mawonekedwe akuwoneka ngati otsika mtengo ku Russia. Pakadali pano, kampani yaku Israeli Teva ikuyesayesa kulembetsa mankhwala omwe ali ndi zomwezi, zomwe zimapangidwa ndiukadaulo wake. Komabe, NovoNordisk imatsutsa mwamphamvu mawonekedwe a generic. Kampaniyo akuti njira yopangirayo ndiyovuta kwambiri kotero sizingatheke kukhazikitsa kufanana kwa analogues. Ndiye kuti, atha kukhala mankhwala omwe ali ndi ntchito yosiyaniratu ndi zina kapena kuperewera kwa zinthu zofunika.

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

Zotsatira zoyipa

Wowonongera angayambitse:

• nseru kutsegula m'mimbakusanza, kupweteka m'mimba,
• kuchepa kwamtima kukomoka,
• Hypoglycemic zinthu,
• mutu
• zimachitika malo jakisoni,
• matenda kupuma thirakiti.

Malangizo ogwiritsira ntchito Victoza (Njira ndi Mlingo)

S / c imalowetsedwa m'mimba / ntchafu kamodzi patsiku, ngakhale chakudya.

Ndikofunika kulowa nthawi yomweyo. Tsamba la jakisoni limatha kusiyanasiyana. Mankhwala sangathe kulowa / mkati ndi / m.

Amayamba chithandizo ndi 0,6 mg patsiku. Pambuyo pa sabata, mlingo umakulitsidwa ku 1,2 mg. Ngati ndi kotheka, kuti muthane ndi vuto labwino kwambiri la glycemic, onjezerani 1.8 mg pambuyo pa sabata. Mlingo pamwambapa 1.8 mg ndi osayenera.
Nthawi zambiri imagwiritsidwa ntchito kuwonjezera pa chithandizo. Metforminkapena Metformin+ PizzMlingo wam'mbuyomu. Akaphatikizidwa ndi mankhwala a sulfonylurea, mlingo wotsiriza uyenera kuchepetsedwa, chifukwa osayenera hypoglycemia.

Kuchita

Mukutenga Paracetamol Mlingo wa chomaliza suyenera kusintha.

Sizimayambitsa kusintha kwakukulu mu pharmacokinetics Atorvastatin.

Mlingo Griseofulvin kugwiritsa ntchito Victoza munthawi yomweyo sikofunikira.

Komanso palibe kukonza Dozlisinoprilndi Digoxin.

Kuletsa kubereka Ethinyl estradiolndi Levonorgestrel pamene kutenga ndi Viktoza sikusintha.

Kugwiritsa ntchito mankhwala osokoneza bongo Insulinndi Warfarin osati kuphunzira.

Ndemanga za Victoza

Ndemanga za madotolo za Viktoz amabwera kudzavomereza kuti mankhwalawa amayenera kugwiritsidwa ntchito molingana ndi zofunikira komanso pokhapokha ngati adokotala akuwalangiza. Kafukufuku awonetsa kuti mankhwala othandizira odwala matenda amtundu wa 2, Baeta ndi Victoza, ndi othandiza kuchepetsa kunenepa kwambiri. Izi ndizofunikira chifukwa ntchito yofunika kwambiri pothandizira odwala omwe ali ndi vutoli ndi kuwonda.

Mankhwalawa amapangidwira KUTHENGA matenda ashugandi kupewa zovuta zake, zimakhudza mtima wamtima. Sizingochepetsa kuchuluka kwa shuga, komanso kubwezeretsa kupanga kwa insulin mwa odwala matenda ashuga. Poyeserera nyama, zinatsimikiziridwa kuti mothandizidwa ndi kapangidwe ka maselo a beta ndikugwira ntchito kwawo zimabwezeretseka. Kugwiritsa ntchito mankhwalawa kumalola njira yovomerezeka yothandizira Type 2 shuga.

Viktoza wochepetsa thupi mwa odwala ena omwe ali ndi matenda ashuga adagwiritsidwa ntchito ngati monotherapy. Odwala onse adazindikira kuchepa kwakudya. Zizindikiro zamagalasi am'magazi masana zinali zopanda malire, momwe zimakhalira kubwerera mwezi umodzi triglycerides.

Mankhwalawa adapangidwa pa mlingo wa 0,6 mg kamodzi patsiku kwa sabata, ndiye kuti mlingowo unakwezedwa mpaka 1.2 mg. Kutalika kwa chithandizo ndi chaka chimodzi. Zotsatira zabwino zimawonedwa ndi kuphatikiza mankhwala ndi Metformin. M'mwezi woyamba wa chithandizo, odwala ena adataya 8 kg. Madotolo amachenjeza kuti asamangotsatira mankhwalawa kwa omwe akufuna kuchepa thupi. Kugwiritsa ntchito kumakhala ndi ngozi khansa ya chithokomiro ndi zochitika kapamba.

Ndemanga pamapulogalamu nthawi zambiri zimakhala zoipa. Kutaya kambiri kumalemera pafupifupi 1 kg pamwezi, osachepera 10 kg kwa miyezi isanu ndi umodzi. Funso lomwe likufunsidwa mwachangu: kodi pali tanthauzo lililonse kusokoneza metabolism chifukwa cha 1 kg pamwezi? Ngakhale kuti zakudya ndi masewera olimbitsa thupi zimafunikirabe.

"Kupotoza kagayidwe ... ayi."

"Ndikuvomereza kuti chithandizo chamankhwala ndikofunikira kuti magawo atatu a minyewa ya thupi athe, pamene metabolism itasokonekera, koma apa? Sindikumvetsa ... "

"Ku Israel, mankhwalawa amalembedwa PAMODZI kwa odwala matenda ashuga omwe ali ndi shuga. Ungopeza chophikacho. "

“Palibe chabwino pankhani imeneyi. Kwa miyezi itatu + 5 kg. Koma sindinatengereko kuti ndichepe thupi, ndili ndi matenda ashuga. ”

Kodi liraglutide ndi chiyani?

Liraglutide ndi analogue yabwinobwino yamahomoni ake - glucagon-ngati peptide-1 (GLP-1), yomwe imapangidwa m'mimba yotsatila poyankha kudya ndipo imayambitsa kuphatikiza kwa insulin. Natural GLP-1 imawonongeka m'thupi pakangotha ​​mphindi zochepa, kapangidwe kameneka kamasiyanasiyana mu izi mwa ma 2 amino acid omwe amapangidwira mankhwala. Mosiyana ndi munthu (wobadwira) GLP-1, liraglutide imasunga ndende nthawi yayitali, yomwe imalola kuti iperekedwe kamodzi kokha mu maola 24.

Amapezeka mu mawonekedwe a yankho lomveka bwino, amagwiritsidwa ntchito ngati ma jakisoni a subcutaneous mu mlingo wa 6 mg / ml (gawo lathunthu la 18 mg kwathunthu). Kampani yoyamba yopanga inali kampani yaku Danish Novo Nordisk. Mankhwalawa amaperekedwa ku pharmacies monga mawonekedwe a cartridge, odzaza ndi cholembera, komwe jakisoni ya tsiku ndi tsiku imapangidwa. Mulingo uliwonse umakhala ndi 3 ml ya yankho, mu phukusi la zidutswa ziwiri kapena zisanu.

Pharmacological zochita za mankhwala

Mothandizidwa ndi yogwira - liraglutide, yolimbikitsanso kupanga insulin, ntchito ya β-cell imakhala bwino. Pamodzi ndi izi, kuchuluka kwambiri kwa mahomoni omwe amadalira shuga - glucagon - amaponderezedwa.

Izi zikutanthauza kuti chifukwa chokhala ndi shuga wambiri wam'magazi, kupanga kwake kwa insulin kumawonjezeka ndipo kubisalira kwa glucagon kumachepetsa. Zotsutsana ndi izi, kuchuluka kwa glucose kutsika, insulin secretion imachepa, koma kaphatikizidwe ka glucagon kamatsalira pamlingo womwewo.

Mphamvu yosangalatsa ya liraglutide ndi kuchepa thupi komanso kuchepa kwa minofu ya adipose, yomwe imakhudzana mwachindunji ndi limagwirira lomwe limathetsa njala komanso kuchepetsa mphamvu.

Kafukufuku kunja kwa thupi awonetsa kuti mankhwalawa amatha kupereka mphamvu mwamphamvu m'maselo a β, ndikuchulukitsa kuchuluka kwawo.

Liraglutide nthawi yapakati

Palibe maphunziro apadera omwe adachitidwa pagululi la odwala, chifukwa chake mankhwalawo ndi oletsedwa kuti azigwiritsidwa ntchito. Kafukufuku wokhudza nyama yamulembera asonyeza kuti chinthuchi ndichoperewera kwa mwana wosabadwa. Akamagwiritsa ntchito mankhwalawa, mayi ayenera kugwiritsa ntchito njira zakulera zokwanira, ndipo ngati akufuna kubereka, ayenera kudziwitsa adokotala za lingaliro ili kuti amupereketse ku mankhwala otetezeka.

Kusanthula mwalamulo kwa mankhwalawa

Kuchita bwino kwa chinthu chomwe chikugwiriridwa chinafufuzidwa ndi pulogalamu ya mayeso azaumoyo a LEAD. Anthu 4000 omwe ali ndi matenda a shuga a 2 adapereka phindu lawo kwambiri.Zotsatira zake zidawonetsa kuti mankhwalawa ndi othandiza komanso otetezeka monga chithandizo chachikulu, komanso mapiritsi ena ochepetsa shuga.

Zinadziwika kuti anthu omwe amamwa liraglutide nthawi yayitali amachepetsa thupi komanso kuthamanga magazi. Kuchuluka kwa hypoglycemia kumachepera nthawi 6, ndikuyerekeza ndi glimepiride (Amaril).

Zotsatira za pulogalamuyi zidawonetsa kuti kuchuluka kwa hemoglobin komanso kulemera kwa thupi kumachepetsa kwambiri liraglutide kuposa insulin glargine yophatikizana ndi metformin ndi glimepiride. Adalembedwa kuti ziwerengero zamagazi amatsitsidwa pambuyo pa sabata 1 logwiritsa ntchito mankhwalawa, zomwe sizimadalira kuchepa thupi.

Zotsatira zomaliza:

• kuonetsetsa phindu la hemoglobin
• kutsitsa kuchuluka kwapamwamba kwa kuthamanga kwa magazi,
• kutayika kwa mapaundi owonjezera.

Ubwino ndi zoyipa zamagwiritsidwe

• Imatha kutha kudya komanso kuchepetsa thupi.
• Imachepetsa kuwopsa kwa zovuta zazikulu zomwe zimakhudzana ndi CVS.
• Amagwiritsidwa ntchito kamodzi patsiku.
• Malingana momwe mungathere, imasungirako ntchito ya β-cell.
• Chimalimbikitsa kapangidwe ka insulin.

• Ntchito yolowerera.
• Anthu olumala owoneka bwino amatha kukumana ndi zovuta zina akamagwiritsa ntchito cholembera.
• Mndandanda waukulu wamakampani.
• Sizingagwiritsidwe ntchito ndi amayi apakati, oyembekezera komanso ana ochepera zaka 18.
• Mtengo wokwera wa mankhwala.

Kodi pali ma fanizo?

Mankhwala omwe amangokhala ndi liraglutide:

Mankhwala ophatikizidwa, kuphatikiza pake ndi insulin degludec - Sultofay.

Zitha kusintha liraglutide

Ndemanga Kanema wa Mankhwala Opepuka

Poganizira za mankhwalawa Viktoza ndi Saksenda malinga ndi zachuma, titha kunena kuti mankhwala oyamba atenga ndalama zochepa. Ndipo sikuti sikuti amangogulira zochepa, koma kuti mulingo wambiri watsiku ndi tsiku ndi 1.8 mg, pomwe winayo ali ndi 3 mg. Izi zikutanthauza kuti 1 cartridge ya Victoza ndi yokwanira masiku 10, ndipo Saxend - kwa 6, ngati mutamwa mlingo waukulu.

Ndemanga Zahudwala

Marina Ndimadwala matenda a shuga a 2 kwa pafupifupi zaka 10, ndimamwa metformin ndikumenya insulin, shuga ndiwokwera 9-11 mmol / l. Kulemera kwanga ndi makilogalamu 105, adotolo adalimbikitsa kuyesa Viktoza ndi Lantus. Patatha mwezi umodzi, adataya makilogalamu 4 ndipo shuga adasungidwa m'magawo 7-8 mmol / L.

Alexander Ndikhulupirira kuti ngati metformin ikuthandizira, ndibwino kumwa mapiritsi. Mukasinthira kale ku insulin, ndiye kuti mutha kuyesa liraglutide.

Kodi mankhwalawa amagwira ntchito bwanji?

Liraglutid mu radar (renti la mankhwala ku Russia) walowa pansi pa mayina amalonda Viktoza ndi Saksenda. Mankhwalawa ali ndi chigawo chofunikira cha liraglutide, chophatikizidwa ndi zosakaniza: sodium hydrogen phosphate dihydrate, phenol, sodium hydroxide, madzi ndi propylene glycol.

Monga GLP-2 yachilengedwe, liraglutide imakumana ndi ma receptors, zomwe zimapangitsa kupanga insulin ndi glucagon. Njira za kaphatikizidwe ka mankhwala amkati mwa insulin zimapangika pang'onopang'ono. Njira imeneyi imakuthandizani kuti musinthe glycemia mokwanira.

Mankhwalawa amawongolera kukula kwamafuta amthupi pogwiritsa ntchito njira zomwe zimaletsa njala komanso kugwiritsa ntchito mphamvu. Kuchepetsa thupi mpaka 3 makilogalamu kudalembedwa panthawi ya mayesero azachipatala pogwiritsa ntchito Saxenda panjira yovuta ndi metformin. Kutalika kwa BMI koyambirira koyambirira, kuthamanga kumawadwala odwala.

Ndi monotherapy, voliyumu ya m'chiuno inachepetsedwa ndi 3-3.6 masentimita pachaka chonse, ndipo kulemera kunatsika mpaka madigiri osiyanasiyana, koma mwa odwala onse, mosasamala kanthu za kukhalapo kwa zotsatira zosasangalatsa. Pambuyo poteteza mawonekedwe a glycemic, liraglutide imaletsa kukula kwa maselo a b omwe ali ndi vuto la kapangidwe ka insulin yawo.

Pambuyo pa jekeseni, mankhwalawa amalowetsedwa pang'onopang'ono. Pachimake pazowawa zake zimawonedwa patatha maola 8-12. Kwa pharmacokinetics a mankhwalawa, zaka, jenda kapena kusiyana kwa mafuko satenga mbali yapadera, monga momwe zimakhalira ndi chiwindi ndi impso.

Nthawi zambiri, mankhwalawa amalowa m'magazi ndi jakisoni, kukulitsa kuchuluka kwa peptides, kubwezeretsa kapamba. Chakudya chimatengedwa bwino, zizindikiritso za mtundu wachiwiri wa shuga sizachilendo.

Zoyesa zamankhwala zimachitika mchaka, ndipo palibe yankho losatsutsika pafunso la nthawi ya chithandizo. FDA ilimbikitsa kuyesa odwala miyezi 4 iliyonse kuti asinthe ma regimen.

Ngati munthawi imeneyi kuwonda kumakhala kochepera 4%, ndiye kuti mankhwalawo sioyenera kwa wodwala, ndipo m'malo mwake muyenera kufunafuna ena.

Momwe mungathanirane ndi kunenepa kwambiri ndi liraglutide - malangizo

Mlingo wa mankhwala mu mawonekedwe a cholembera umathandizira kuti azigwiritsa ntchito. Syringe imakhala ndi chizindikiritso chomwe chimakupatsani mwayi kuti mupeze mlingo wofunikira - kuchokera ku 0.6 mpaka 3 mg ndi gawo la 0.6 mg.

Mulingo wapamwamba wa tsiku ndi tsiku wa liraglutide malinga ndi malangizo ogwiritsira ntchito ndi 3 mg. Nthawi inayake, kumwa mankhwala kapena chakudya, jakisoni samangidwa. Mlingo woyambira sabata yoyamba ndi wocheperako (0.6 mg).

Pakatha sabata, mutha kusintha zomwe zimasintha mu 0.6 mg. Kuyambira mwezi wachiwiri, pamene kuchuluka kwa mankhwalawa kumafikira 3 mg / tsiku, ndipo mpaka kumapeto kwa maphunzirowo, kulandira mankhwala osokoneza bongo sikumachitika m'njira yowonjezera.

Mankhwalawa amaperekedwa kamodzi pa tsiku lililonse, malo oyenera a thupi la jekeseni ndi m'mimba, mapewa, m'chiuno. Nthawi ndi malo a jakisoni amatha kusinthidwa, chinthu chachikulu ndikuwonetsetsa kuti mulingowu.

Aliyense yemwe alibe chidziwitso chogwiritsa ntchito zolembera yekha amatha kugwiritsa ntchito njira zake.

1. Kukonzekera. Sambani m'manja, chekeni zowonjezera zonse (cholembera chodzazidwa ndi liraglutide, singano ndi mowa wokuta).
2. Kuyang'ana mankhwalawo m'khola. Iyenera kukhala ndi kutentha kwa malo, madzi amakhala owonekera nthawi zonse.
3. Kuyika singano. Chotsani kapu pachiwono, chotsani chizindikiro kunja kwa singano, ndikuchigwira ndi kapu, ndikuyiyika mu nsonga. Kutembenuza ulusiwo, ndikani singano m'malo otetezeka.
4. Kutha kwa thovu. Ngati mlengalenga muli mpweya, uyenera kuyikika magawo 25, chotsani zisoti pachifuwa ndikutembenuzira chimaliziro. Gwedeza syringe kuti utuluke. Kanikizani batani kuti dontho la mankhwala lituluke kumapeto kwa singano. Ngati palibe madzi, mutha kubwereza njirayi, koma kamodzi.
5. Mlingo woyika. Sinthani batani jakisoni kukhala muyeso wofanana ndi mlingo wa mankhwala omwe dokotala wakupatsani. Mutha kuzungulira mbali iliyonse. Mukazungulira, osakanikiza batani ndikutulutsa. Nambala yomwe ili pawindo iyenera kufufuzidwa nthawi iliyonse ndi mlingo womwe adokotala adapereka.
6. Kubaya Tsambalo la jakisoni liyenera kusankhidwa limodzi ndi adotolo, koma pakakhala zopanda zovuta ndikwabwino kuti musinthe nthawi iliyonse. Tsukani malo a jakisoni ndi swab kapena nsalu yothinidwa ndi mowa, ulole kuti iume. Ndi dzanja limodzi muyenera kugwirizira syringe, ndipo ndi inayo - pangani khungu lanu pamalo a jekeseni yomwe mukufuna. Ikani singano pakhungu ndikumasulidwa. Dinani batani m'manja ndipo dikirani masekondi 10. Singano imatsala pakhungu. Ndiye chotsani singano mutagwira batani.

Malangizo pa kanema pakugwiritsira ntchito cholembera cha Victoza - pa kanemayu

Mfundo ina yofunika: liraglutide yoonda kuchepa thupi siimalo mwa insulin, yomwe nthawi zina imagwiritsidwa ntchito ndi anthu odwala matenda ashuga omwe ali ndi matenda a mtundu 2. Kuchita bwino kwa mankhwalawa m'gulu la odwala sikunaphunzire.

Liraglutide imaphatikizidwa bwino ndi mankhwala omwe amachepetsa shuga potengera metformin ndipo, mwakutulutsa, metformin + thiazolidcediones.

Ndani amasankhidwa liraglutide

Liraglutide ndi mankhwala oopsa, ndipo ndikofunikira kuti mupeze pokhapokha ngati wodwala azakudya kapena endocrinologist. Monga lamulo, mankhwala amalembedwa kwa anthu odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda, makamaka pamaso pa kunenepa kwambiri, ngati kusintha kwa moyo kulola kuti matenda asamakhale ozungulira komanso osakanikirana ndi mankhwala osokoneza bongo.

Kodi mankhwalawa amakhudza bwanji kugwira ntchito kwa mita? Ngati wodwala ali ndi matenda ashuga a mtundu wachiwiri, makamaka ngati akumwa mankhwala owonjezera a hypoglycemic, mbiri ya glycemic ikayamba kuchepa. Kwa odwala athanzi, palibe choopsa cha hypoglycemia.

Zitha kuvulaza mankhwala

Liraglutide imatsutsana pokhapokha pakukhudzidwa kwambiri ndi zosakaniza za formula. Kuphatikiza apo, mankhwalawa sanalembedwe:

1. Anthu odwala matenda ashuga a mtundu woyamba,
2. Ndi matenda akulu a chiwindi ndi impso,
3. Odwala omwe mtima walephera 3 kapena 4,
4. Ngati pali mbiri yakutupa kwamatumbo,
5. Amayi oyembekezera komanso oyembekezera
6. Ndi chithokomiro cha chithokomiro,
7. Mu matenda a diabetes ketoacidosis,
8. Odwala omwe ali ndi mitundu yambiri ya endocrine neoplasia syndrome.

Malangizowo salimbikitsa kumwa liraglutide limodzi ndi jakisoni wa insulini kapena ena okana ndi GLP-1. Pali zoletsa zaka: mankhwalawa saikidwa kwa ana ndi anthu okhwima (atatha zaka 75), popeza maphunziro apadera a gulu ili la odwala sanachitidwe.

Ngati pali mbiri ya kapamba, mankhwalawa sawonjezedwanso, chifukwa palibe chidziwitso chachipatala chokhudza chitetezo chake m'gulu ili la odwala.

Kuyesa kwa zinyama kwatsimikizira kuopsa kwa kubereka kwa metabolite, chifukwa chake, pa gawo lokonzekera kubereka, liraglutide iyenera m'malo mwa insal insulin. Muzoyamwa zazikazi zazikazi, kuchuluka kwa mankhwalawa mkaka kunali kochepa, koma izi sizokwanira kutenga liraglutide pa mkaka wa mkaka.

Palibe zokuchitikirani ndi mankhwalawa ndi ma analogu ena omwe amagwiritsidwa ntchito kukonza kulemera. Izi zikutanthauza kuti ndizowopsa kuyesa njira zingapo za kuchepetsa thupi panthawi ya mankhwala a liraglutide.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri ndizovuta zam'mimba. Pafupifupi theka la odwala amadandaula ndi mseru, kusanza, kupweteka kwa epigastric. Wachisanu aliyense amakhala ndi kuphwanya mtundu wa defecation (pafupipafupi - kutsegula m'mimba ndi madzi am'mimba, koma akhoza kudzimbidwa). 8% ya odwala omwe amachepetsa thupi amamva kutopa kapena kutopa kosalekeza.

Anthu odwala matenda ashuga omwe ali ndi mtundu wachiwiri wamatendawa ayenera kuwonetsetsa kuti ali ndi vuto lofooka, popeza 30% ya omwe amatenga liraglutide nthawi yayitali amalandila zovuta monga hypoglycemia.

Zotsatira zotsatirazi sizachilendo mukamalandira mankhwala:

• Mutu
• Mbale, maluwa,
• Beling, gastritis,
• Anachepetsa chilakolako chofuna kudya,
• Matenda opatsirana am'mapapo,
• Tachycardia
• Kulephera kwina
• Thupi lawo siligwirizana chikhalidwe chakumudzi (mu jekeseni zone).

Popeza mankhwalawa amayambitsa zovuta ndikutulutsa kwa m'mimba, izi zimatha kukhudza mayamwidwe ena am'magazi ena. Palibe kusiyana kwakanthawi kachipatala, motero palibe chifukwa chosinthira kuchuluka kwa mankhwala omwe amagwiritsidwa ntchito povuta mankhwala.

Bongo

Zizindikiro zazikulu za bongo ndi kukanika kwa msana mu mseru, kusanza, kufooka. Panalibe milandu yachitukuko cha machitidwe a hypoglycemic, ngati mankhwala ena sanatengedwe nthawi yomweyo kuti muchepetse thupi.

Malangizo ogwiritsira ntchito liraglutide amalimbikitsa kutuluka kwam'mimba kuchokera kumankhwala omwe amapezeka ndimankhwala ndipo metabolites yake imagwiritsa ntchito ma sorbents ndi dalili.

Kodi mankhwala amathandizira bwanji kuti muchepetse kunenepa?

Mankhwala ozikidwa ndi mankhwala opangira liraglutide amathandizira kuchepetsa kulemera kwa thupi pochepetsa kuchepa kwa chakudya m'mimba. Izi zimathandizira kuchepetsa kulakalaka ndi 15-20%.

Kuti muwonjezere mphamvu ya liraglutide pochizira kunenepa, ndikofunikira kuphatikiza mankhwala ndi michere ya hypocaloric. Ndikosatheka kukwaniritsa chithunzi chabwino ndi jakisoni imodzi yokha. Muyenera kuwunika zochita zanu zoyipa, muzichita zovuta kuti mukhale athanzi komanso zaka zolimbitsa thupi.

Ndi njira yokwanira yothetsera vutoli, 50% ya anthu onse athanzi omwe amaliza maphunziro athunthu komanso kotala la odwala matenda ashuga amachepa. Mugawo loyamba, kuchepa thupi kudalembedwa pafupifupi 5%, wachiwiri - ndi 10%.

Liraglutide - analogues

Kwa liraglutide, mtengo umachokera ku ruble 9 mpaka 27,000, kutengera mlingo. Kwa mankhwala oyamba, omwe amagulitsidwanso pansi pa dzina la malonda a Viktoza ndi Saksenda, pali mankhwala omwe ali ndi vutoli.

Baeta - amino acid amidopeptide yomwe imachepetsa kutsanulira kwam'mimba, imachepetsa chilimbikitso, mtengo wa cholembera chokhala ndi mankhwala ndi mpaka ma ruble 10,000.

Mapiritsi ngati Liraglutide amatha kukhala osavuta kugwiritsa ntchito, koma jakisoni wa cholembera wakhala othandiza kwambiri.. Mankhwala othandizira amapezeka. Mtengo wokwera wa mankhwala osangalatsa nthawi zonse umalimbikitsa maonekedwe a nsomba ndi mitengo yokongola pamsika.

Zomwe analogue ndizothandiza kwambiri, ndi adokotala okha omwe angadziwe. Kupanda kutero, chithandizo chamankhwala ndi kuchuluka kwa zotsatira zosayenera sizingachitike.

Ndemanga ndi zotsatira za chithandizo

M'chaka, odzipereka 4800 adatenga nawo mbali pazoyeserera zamankhwala ku USA, 60% ya iwo adatenga 3 mg ya liraglutide patsiku ndipo adataya osachepera 5%. Gawo lachitatu la odwala lidachepetsa 10%.

Akatswiri ambiri sawona kuti zotsatila zake ndizofunika kwambiri kwa mankhwala omwe ali ndi zovuta zingapo. Pa liraglutide, kuwunika kwa kunenepa kwakanthawi kumatsimikizira ziwerengerozi.

Mukafuna kuchepetsa thupi ndi Lyraglutide, zotsatira zabwino zimatheka ndi omwe amathetsa vutoli:

• Amakhala ndi zakudya zochepa zopatsa mphamvu
• Amakana zizolowezi zoyipa,
• Kuchulukitsa kwamisempha
• Amapanga malingaliro abwino ndi chikhulupiriro pazotsatira zamankhwala.

Ku Russian Federation, orlistat, sibutramine ndi liraglutide adalembetsa kuchokera ku mankhwala ochepetsa. Pulofesa Endocrinologist E. Troshina adaika liraglutide pamalo oyamba pankhani yogwira bwino pamndandanda uno. Zambiri pa kanema