Sitagliptin kuti azilamulira kudya komanso kulimbitsa thupi

Sitagliptin imapezeka mu mawonekedwe a phosphate monohydrate. Kutulutsidwa ndi piritsi yokhala ndi filimu

Chipangizocho ndi chosiyana kwambiri ndi kapangidwe kake monga mankhwala ndi mankhwala ena opanga mankhwala ochokera ku sulfonylureas, biguanides ndi alpha-glycosidase inhibitors.

Kuletsa kwa DPP 4 ndi Sitagliptin kumabweretsa kuwonjezereka kwa kuchuluka kwa mahomoni awiri GLP-1 ndi HIP. Ma mahormonewa ndi a banja la ma incretin. Kubisika kwa mahomoni awa kumachitika m'matumbo.

Kuzungulira kwa mahomoni awa kumawonjezeka chifukwa cha kudya. Ma incretins ndi gawo limodzi la thupi lomwe limapereka shuga homeostasis mthupi.

Pharmokinetics ndi mawonekedwe ogwiritsira ntchito mankhwalawa

Mutatha kumwa mankhwalawo, mankhwalawo amatengeka mwachangu. Mankhwala ali bioavailability mtheradi 87%. Kudya zakudya zamafuta sikukhudza kwambiri mankhwala a pharmacological kinetics.

Kuchoka kwa mankhwala ikuchitika osasinthika zikuchokera mkodzo. Atayimitsa mankhwalawo kwa sabata limodzi, 87% ndi mkodzo ndi 13% yokhala ndi ndowe amachotsedwanso.

Mankhwala amagwiritsidwa ntchito ngati njira ya monotherapy pamaso pa mtundu II matenda a shuga m'm wodwala. Mankhwalawa amaloledwa kumwa mosasamala chakudya. Sitagliptin ndi Metformin kuphatikiza ingagwiritsidwe ntchito ngati zovuta kuchiritsa pamaso pa mtundu 2 wa shuga. Mlingo woyenera kumwa mankhwalawa kuphatikiza ndi Metformin ndi 100 mg kamodzi patsiku.

Ngati mukusowa nthawi yoti mutenge Sitagliptin, muyenera kuitenga posachedwa. Izi ndichifukwa choti kumwa kuchuluka kwa mankhwalawa ndikosavomerezeka.

Ndi zoletsedwa kumwa mankhwalawa pafupipafupi kuposa momwe amalangiziridwa ndi malangizo.

Chidacho chimakupatsani mwayi wowongolera kuchuluka kwa shuga mthupi, koma mankhwalawa samachiza matenda a shuga.

Mankhwalawa amayenera kumwedwa ngakhale wodwala akumva bwino, ayenera kusiyidwa pokhapokha atakambirana ndi adokotala komanso pakulimbikitsa.

Malangizo ogwiritsira ntchito mankhwalawa

Sitagliptin ndi mankhwala omwe amalekeredwa bwino akamwedwa ndi odwala, onse panthawi ya monotherapy komanso monga gawo la zovuta ndi mankhwala ena omwe ali ndi katundu wa hypoglycemic.

Kuchoka kwa waukulu mankhwala ndi kudzera impso. Njira iyi yochotsekera yogwira zinthu mthupi imafuna kuti dokotala wofufuza momwe impso zake azigwiritsidwira ntchito pamaso pa wodwalayo asanagwiritse ntchito mankhwala. Ngati ndi kotheka, kukonza kwa mankhwalawa kumachitika. Pamaso pa mawonekedwe ofatsa a impso, kusintha kwa mankhwalawa sikugwiritsidwa ntchito.

Ngati wodwala walephera kwenikweni aimpso, muyezo wa mankhwalawa sayenera kupitilira 50 mg kamodzi patsiku. Mankhwalawa amatha kugwiritsidwa ntchito nthawi iliyonse, mosasamala kanthu za dialysis.

Pogwiritsa ntchito mankhwalawa monga gawo limodzi la mankhwala osokoneza bongo, kuti mupewe kukula kwa sulfon-hypoglycemia mthupi, mulingo woyambira wa sulfonylurea wogwiritsidwa ntchito uyenera kuchepetsedwa.

Kutsimikiza kwa mankhwalawa kwa mankhwala omwe amagwiritsidwa ntchito kumachitika ndi adotolo atatha kufufuza mozama thupi la wodwala omwe ali ndi matenda a shuga a mtundu wachiwiri.

Ngati pali kukaikira kwa chitukuko cha thupi la wodwalayo kapamba, ndikofunikira kusiya kumwa Sitagliptin ndi mankhwala ena omwe angathe kupangitsa kuti matenda awonjezeke.

Musanagwiritse ntchito mankhwalawa, dokotala ayenera kudziwitsa wodwalayo zoyamba za matenda a kapamba.

Contraindication ndi zoyipa

Kugwiritsa ntchito mankhwalawa kumatha kupangitsa kuti zikondamoyo zoyipa zipange munthu.

Kugwiritsa ntchito molakwika mankhwalawa, imatha kupangitsa kukhalapo kwa zoyipa zingapo mthupi. Zizindikiro zoyambazo zikaonekera, pitani kuchipatala msanga.

Mukamagwiritsa ntchito mankhwalawa, malangizo omwe dokotala akupereka ayenera kutsatiridwa mosamala.

Mukamagwiritsa ntchito mankhwalawa, munthu amatha kupeza zovuta zingapo zoyipa. Zotsatira zoyipa zazikulu ndi:

1. angioedema,
2. anaphylaxis,
3. zotupa
4. khungu vasculitis
5. urticaria
6. matenda apakhungu akhungu, matenda a Stevens-Johnson,
7. pachimake kapamba
8. kuwonongeka kwa impso, pachimake aimpso kulephera kwa dialysis,
9. nasopharyngitis,
10. matenda kupuma thirakiti
11. kusanza
12. kudzimbidwa
13. mutu
14. myalgia
15. arthralgia,
16. kupweteka kumbuyo
17. kupweteka kwa miyendo
18. kuyabwa

Mukamagwiritsa ntchito mankhwalawa, ayenera kukumbukira kuti pali mitundu yonse ya zotsutsana pogwiritsira ntchito chida ichi.

Milandu ikuluikulu yomwe imamwa mankhwalawa ndi yotere:

• Hypersensitivity
• kukhalapo kwa matenda a shuga a mtundu woyamba,
• matenda ashuga ketoacidosis,
• Wodwala wosakwana zaka 18
• Nthawi yonyamula mkaka
• nthawi yobala mwana.

Mukamagwiritsa ntchito mankhwala, malingaliro onse ayenera kutsatiridwa mosamalitsa, ndipo mankhwalawo sayenera kumwedwa ngati pali zotsutsana zilizonse zilipo. Ngati mankhwala osokoneza bongo kapena poyizoni atapezeka chifukwa ch kumwa mankhwalawo, muyenera kuyimbira ambulansi nthawi yomweyo.

Mankhwala osokoneza bongo kapena poyizoni wa thupi pogwiritsa ntchito mankhwalawo atha kudzetsa nkhawa mpaka imfa.

Analogi, mtengo wake komanso kulumikizana ndi njira zina

Panthawi ya mayeso azachipatala, kukonzekera kochokera ku sitagliptin kunalibe tanthauzo lalikulu komanso lofunikira pa pharmacological kinetics ya mankhwala monga rosiglitazone, metformin, glibenclamide, warfarin, simvastatin, ndi njira yolerera pakamwa.

Mukamagwiritsa ntchito othandizira malinga ndi sitagliptin, zoletsa za CYP2C8, CYP3A4, CYP2C9 isoenzymes sizimachitika. Kuphatikiza apo, mankhwalawa saletsa enymes CYP1A2, CYP2D6, CYP2B6, CYP2C19.

Kugwiritsa ntchito kwa lesigliptin ndi metformin sikusintha kwenikweni mu pharmacokinetics ya sitagliptin mu shuga mellitus.

Mankhwala ofala kwambiri ndi Januvia. Analogue ya mankhwala aku Russia a Januvia ndi Yanumet, omwe mtengo wake ku Russia ndi pafupifupi ma ruble 2980.

Poyerekeza ndi ndemanga ya odwala omwe adagwiritsa ntchito mankhwalawa mankhwalawa, imakhudzanso kwambiri shuga mu thupi, koma imafunikira kuyang'anira mosamalitsa kwa thupi chifukwa chotsatira cha zotsatira zoyipa zambiri.

Mtengo wa mankhwalawa umatengera dera la dzikolo komanso mapangidwe ake a mankhwalawo ndipo umachokera ku 1596 mpaka 1724 rubles. Kanemayo munkhaniyi akukamba za njira zochizira glycemia.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala omwe amachokera ku sitagliptin okhala ndi dzina la malonda a Januvia akupezeka mozungulira mapiritsi okhala ndi pinki kapena beige hue ndipo amalembedwa "227" kwa 100 mg, "112" kwa 50 mg, "221" kwa 25 mg. Mapiritsiwo amadzaza m'mabokosi apulasitiki kapena pensulo. Pakhoza kukhala ma mbale angapo m'bokosi.

Pulogalamu yogwira yogwira ya sitagliptin phosphate hydrate imaphatikizidwa ndi croscarmellose sodium, magnesium stearate, cellulose, sodium stearyl fumarate, chosakwaniritsidwa cha calcium hydrogen phosphate.

Kwa sildagliptin, mtengo umadalira phukusi, makamaka mapiritsi 28 omwe muyenera kulipira rubles 1,596-1724. Mankhwala othandizira amaperekedwa, moyo wa alumali ndi chaka chimodzi. Mankhwalawa safuna mikhalidwe yapadera kuti asungidwe. Phukusi lotseguka limasungidwa pakhomo la firiji kwa mwezi umodzi.

Pharmacology Sitagliptinum

Ma mahomoni amenewa amapangidwa ndi mucosa wamatumbo, ndipo kupanga ma insretin kumawonjezeka ndi mphamvu ya michere. Ngati kuchuluka kwa glucose ndikwabwinobwino komanso kokulirapo, mahomoni amakula mpaka 80% yopanga insulini komanso chinsinsi chake ndi maselo a β-cell chifukwa cha ma siginecha am'magazi. GLP-1 amalepheretsa kubisalira kwapamwamba kwa ma cell a b-glucagon.

Kuchepa kwa kuchuluka kwa glucagon poyang'ana kumbuyo kwa kuchuluka kwa insulini kumatsimikizira kuchepetsedwa kwa katulutsidwe ka shuga mu chiwindi. Njira izi ndikuwonetsetsa kuti glycemia ikhale yofanana. Zochita za ma insretins zimachepetsedwa ndi mtundu wina wazamoyo, makamaka ndi hypoglycemia, sizimakhudza kaphatikizidwe ka glucagon ndi insulin.

Pogwiritsa ntchito DPP-4, maretretins ndi hydrolyzed kuti apange ma inert metabolites. Polekerera zomwe zimachitika mu puloteni iyi, sitagliptin imachulukitsa zomwe zili ndi ma insulin komanso insulin, zimachepetsa kupanga glucagon.

Ndi hyperglycemia, chimodzi mwazizindikiro zazikulu za matenda amitundu iwiri, njira iyi yothandizira imachepetsa kuchepa kwa hemoglobin wa glycated, shuga ndi glucose pambuyo ponyamula katundu. Mlingo umodzi wa sitagliptin umatha kuletsa kugwira ntchito kwa DPP-4 kwa tsiku, ndikuwonjezera kuchuluka kwa ma insretin m'magazi ndi katatu.

Pharmacokinetics a sitagliptin

Kuyamwa kwa mankhwalawa kumachitika msanga, ndi bioavailability wa 87%. Kuchuluka kwa mayamwa sikudalira nthawi yakudya komanso kapangidwe kake ka chakudya, makamaka, zakudya zamafuta sizisintha magawo a pharmacokinetic magawo a incretin mimetic.

Pakufanana, kugwiritsa ntchito piritsi la 100 mg kumachulukitsa dera lomwe lili pansi pa AUC pamapindikira, komwe kumakhala kofanana ndi kudalirana kwa magawo nthawi, ndi 14%. Mlingo umodzi wa mapiritsi a 100 mg umatsimikizira kuchuluka kwa magawo a 198 l.

Gawo laling'ono la incretin mimetic limapangidwa. Ma metabolites asanu ndi amodzi adadziwika omwe alibe luso lolepheretsa DPP-4. Chilolezo cha renal (QC) - 350 ml / min. Gawo lalikulu la mankhwalawo limachotsedwa ndi impso (79% mu mawonekedwe osasinthika ndi 13% mwanjira ya metabolites), ena onse amatulutsidwa ndi matumbo.

Poona kulemera kwakukulu kwa impso mu odwala matenda ashuga omwe ali ndi mawonekedwe osakhazikika (CC - 50-80 ml / min.), Zizindikiro ndizofanana, ndi CC 30-50 ml / min. kuwerengetsa kwa mfundo za AUC kumawonedwa, pomwe CC ili pansi 30 ml / min. - kanayi. Mikhalidwe imeneyi imalimbikitsa kumwa mankhwala.

Ndi hepatic pathologies ya zolimbitsa mwamphamvu, Cmax ndi AUC ikuwonjezeka ndi 13% ndi 21%. Mitundu yayikulu, ma pharmacokinetics a sitagliptin sasintha kwambiri, chifukwa mankhwalawa amachotsedwa ndi impso.

Ndani akuwonetsedwa incretinomimetic

Mankhwalawa amalembera mtundu wa matenda a shuga a 2 kuwonjezera pa chakudya chochepa cha carb komanso minyewa yokwanira.

Amagwiritsidwa ntchito ngati mankhwala amodzi komanso othandizira pamodzi ndi metformin, sulfonylurea kukonzekera kapena thiazolidinediones. Ndikothekanso kugwiritsa ntchito ma reginens a insulin ngati njirayi ikuthandizira kuthana ndi vuto la insulin.

Contraindication ya sitagliptin

Osakupatsani mankhwala:

• Ndi chidwi chachikulu chamunthu,
• Anthu odwala matenda ashuga a mtundu woyamba,
• Amayi oyembekezera komanso oyamwitsa,
• Mu matenda a diabetes ketoacidosis,
• Kwa ana.

Makamaka chidwi ndi odwala matenda ashuga omwe ali ndi mtundu wa matenda a impso.

Zochitika Zosiyanasiyana

Poyerekeza ndi ndemanga, ambiri a anthu odwala matenda ashuga amakhudzidwa ndi dyspepsia, chopsinjika. Mu mayeso a labotale, hyperuricemia, kuchepa kwa mphamvu ya chithokomiro, komanso leukocytosis amadziwika.

Mwa zina zomwe sizinachitike (kulumikizana ndi incretin mimetic sizinatsimikizidwe) - matenda opumira, arthralgia, migraine, nasopharyngitis). Zowopsa za hypoglycemia ndizofanana ndi zotsatira zomwe gulu lolamulira likulandira placebo.

Zotsatira Zogwiritsa Ntchito Mankhwala

Ndi munthawi yomweyo kugwiritsa ntchito sitagliptin ndi metformin, rosiglitazone, kulera kwapakamwa, glibenclamide, warfarin, simvastatin, pharmacokinetics ya gululi la mankhwalawa sasintha.

Yomwe imayendetsedwa ndi sitagliptin ndi digoxin sizitanthauza kusintha kwa mankhwalawa. Malangizo ofanana amaperekedwa ndi malangizo komanso mogwirizana ndi sitagliptin ndi cyclosporin, ketoconazole.

Sildagliptin - analogues

Sitagliptin ndi dzina lapadziko lonse la mankhwalawa; dzina lake la malonda ndi Januvius. Analogue imatha kuganiziridwa ngati mankhwala a Yanumet ophatikizidwa, omwe amaphatikizapo sitagliptin ndi metformin. Galvus ilinso ya gulu la DPP-4 zoletsa (Novartis Pharma AG, Switzerland) yokhala ndi yogwira vildagliptin, mtengo 800 rubles.

Mankhwala a Hypoglycemic ndi oyeneranso ndi code ya ATX ya mulingo 4:

• Nesina (Takeda Pharmaceuticals, USA, kutengera alogliptin),
• Onglisa (Bristol-Myers squibb Company, kutengera saxagliptin, mtengo - 1800 rubles),
• Trazhenta (Bristol-Myers squibb Company, Italy, Britain, ndi yogwira mankhwala linagliptin), mtengo - 1700 rubles.

Mankhwalawa akuluakulu sakuphatikizidwa pamndandanda wazokonda, kodi ndikoyenera kuyesa pachiwopsezo chanu ndikuwopseza bajeti ndi thanzi lanu?

Ndemanga za Sitagliptin

Poyerekeza ndi malipoti pamisonkhano yamatenda, Januvius nthawi zambiri amalembedwa kuti azikhala ndi matenda ashuga koyambirira kwa matendawa. About sitagliptin, kuwunika kwa madokotala ndi odwala kukuwonetsa kuti kugwiritsa ntchito incretinomimetic kumakhala ndi malingaliro ambiri.

Januvia ndi mankhwala atsopano ndipo si madokotala onse amene apeza chida chokwanira chogwiritsira ntchito. Mpaka posachedwa, metformin inali mankhwala oyamba; tsopano, Januvia amadziwikanso ngati monotherapy. Ngati kuthekera kwake kuli kokwanira, kuiwonjezera ndi metformin ndi mankhwala ena sikofunikira.

Odwala matenda ashuga amadandaula kuti mankhwalawa samakwaniritsa zomwe zanenedwa, pakapita nthawi ntchito yake imachepa. Vuto pano silikuzolowera mapiritsi, koma mawonekedwe a matendawa: matenda a shuga a 2 ndi njira yokhazikika.

Ndemanga zonse zimabweretsa mawu akuti kuyambitsidwa kwachipatala cha sitagliptin, komwe ndi gulu latsopanoli, kumapereka mwayi wowongolera matenda amtundu wa 2 shuga nthawi iliyonse, kuyambira prediabetes mpaka mankhwala owonjezera, osakhala ndi zotsatirapo zabwino pakugwiritsa ntchito njira zamalipiro zachikhalidwe za glycemic.

Nkhani ya Pulofesa A.S. Ametov, endocrinologist-diabetesologist ponena za chiphunzitso ndi chizolowezi chogwiritsa ntchito sitagliptin - pa kanema.

Zizindikiro zogwiritsidwa ntchito

Sitagliptin ndiwothandiza kukhazikika m'magulu a shuga ambiri, koma siwothandiza pamankhwala ake. Zisonyezo mu pharmacokinetics za sitagliptin sizimayimira pazokha, kulemera kwa odwala komanso nthawi yakudya. Mankhwalawa amachita mosadalira kudya zakudya zamafuta osasintha zomwe ali nazo.

Sitagliptin yadzikhazikitsa yokha ngati njira yolumikizira chithandizo choyambirira, popeza odwala ambiri omwe ali ndi matenda amtundu wa 2 amakhala ndi zovuta pakudya, komanso amachita masewera olimbitsa thupi omwe amafunikira.

Sitagliptin amachepetsa kudya, kwinaku akukhalitsa wamtali wokhalitsa. Izi zimathandiza odwala omwe ali ndi matenda ashuga, akuvutika kwambiri ndi kunenepa.

Kulephera kwina

Impso ndi zomwe zimapangitsa kuti mankhwalawo achotsedwe mthupi, chifukwa cha kulephera kwa impso, kuyezetsa kwamikodzo mthupi lonse kuyenera kuchitika. Pankhani ya mawonekedwe ofatsa, mlingo sasinthidwa, mwakuya mwamlimba amasinthidwa kukhala 50 mg patsiku.

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Ngati dialysis ichitidwa, kugwiritsa ntchito Sitagliptin kumawerengedwa payekhapayekha, kutengera kuwuma kwa chithunzi cha matenda. Pogwiritsidwanso ntchito ndi Sitagliptin, ndikofunikira kupenda pafupipafupi kuwunika kwa mkodzo kwathunthu.

Gwiritsani ntchito mu ukalamba

Malinga ndi kafukufuku mu okalamba, kuchuluka kwa sitagliptin m'magazi ndikokwera 20% kuposa m'badwo wachinyamata. Komabe, malingana ndi mawonekedwe a kukonzanso, sizofunikira, chifukwa mu zovuta zovuta mankhwalawa adagwira ntchito bwino m'gululi la odwala matenda a shuga a mtundu wachiwiri.

Kuphatikiza ndi mankhwala ena

Sitagliptin imathandizira bwino, osasintha ma pharmacokinetics a mankhwala monga:

• metformin
• warfarin
• simvastatin
• glibenclamide,
• cyclosporin
• ketoconazole,
• digoxin
• kulera kwamlomo.

Pankhaniyi, mankhwalawa safuna kusintha kwa mlingo.

Zotsatira zoyipa

Amawonjezera chiopsezo chotenga pancreatitis. Ngati zizindikiro za matenda zimachitika, siyani kumwa mankhwalawa. Mukamamwa ndi sulfonylurea muyezo wabwino, amachepetsa kwambiri shuga.

Mtundu wachiwiri wa odwala matenda ashuga, munthu akhoza kukumana ndi vuto lotsatira la Sitagliptin. Muyenera kufunsa dokotala ngati:

• kupweteka kumbuyo ndi miyendo,
• kusanza kapena kudzimbidwa kwa nthawi yayitali,
• zizindikiro zosatsimikizika za SARS kapena kufupika kwa mpweya,
• mutu
• amaganiza kuti kapamba
• anaphylaxis wokhala ndi mitsempha ya m'maso,
• Khungu loyipa kapena lotupa mu mawonekedwe a urticaria,
• madera akuluakulu ofiira pakhungu,
• kulephera kwa aimpso.

Bongo

Mankhwala osokoneza bongo a sitagliptin ndi osavomerezeka. Ngati mlingo wowirikiza wa mankhwalawo ungakhale kuti akukayikiridwa kapena akuyembekezeka (chikuchitika mwa odwala okalamba), chisamaliro chodzidzimutsa chimayenera kutchedwa yomweyo.

Zofanizira zonse za Sitagliptin zimakhala ndi gawo lalikulu. Pazokonzekera zomwe zakonzedwa, Sitagliptin ndi Metformin ndizofanana.Tebulo limawonetsa zomwe zidasankhidwa kale.

Dokotala adakhazikitsa sitagliptin kuwonjezera pa metformin. Malinga ndi malangizo ogwiritsira ntchito, impso zidawunikanso. Pambuyo powerenga ndemanga zambiri, ndinali wokonzekera zovuta, koma mwamwayi zidandipatsira. Ndimamva bwino pambuyo pa sabata logwiritsa ntchito.

Nikolay, mzinda wa Krasnoyarsk

Sitagliptin ndi zithunzi zake zimasintha matendawo. Nthawi yoyamba pambuyo pokhazikitsidwa ndi maphunzirowo anali kumva chizungu komanso kudandaula pang'ono, koma patatha sabata limodzi zonse zidayamba zabwinobwino.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wambiri wamagazi ndi woopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Kapangidwe ndi kapangidwe ka zochita

Chofunikira chachikulu pa mankhwalawa ndi sitagliptin ya dzina lomweli. Dzina lachi Latin la mankhwalawa ndi Sitagliptin. Ndi shuga wabwinobwino kapena wokwezeka wamagazi, mankhwalawa amathandizira kupanga insulin, kutulutsa kwa mahomoni ndi maselo a beta mu kapamba, chifukwa chotsatira chogwiritsira ntchito ma siginolo am'mimba.

Mutatha kumwa mankhwalawa, kupopera mwachangu kumachitika. Sitagliptin imadziwika ndi bioavailability mtheradi - 87%. Ngakhale kugwiritsa ntchito zakudya zamafuta sikukhudza ma pharmacokinetics a mankhwalawa.

Mankhwalawa amachotsedwa mu mkodzo mobwerezabwereza, ndipo atasiya kumwa mankhwala kwa sabata limodzi, amakhala 87% ndi mkodzo ndipo 13% ali ndi ndowe.

Malangizo ogwiritsira ntchito mankhwalawa

Malinga ndi malangizo ogwiritsira ntchito, Sitagliptin amatchulidwa ngati mankhwala a bungwe la monotherapy a odwala matenda ashuga omwe ali ndi matenda amtundu wachiwiri. Mapiritsi amatha kuledzera mosasamala chakudya.

Kuphatikiza kwa sitagliptin ndi mankhwala omwe ali ndi metformin ndikothekanso kwa odwala matenda ashuga a fomu yachiwiri. Mlingo woyenera ndi munthawi yomweyo chithandizo ndi metformin - 100 mg kamodzi patsiku.

Ngati nthawi ya mapiritsi idasowa, ndiye kuti muyenera kumwa nthawi yomweyo, chifukwa kumwa mankhwalawa panthawi imodzi ndizoletsedwa. Amapangidwanso kuti amwe mapiritsi nthawi zambiri kuposa momwe malangizowo amafotokozera.

Sitagliptin imawongolera shuga m'magazi, koma mchitidwewo umalimbana ndikuchotsa zisonyezo za matenda ashuga, osasiya kuyimitsa zinthu zomwe zimayambitsa thupi.

Amafunika kumwa mapiritsi ngakhale amakhalanso athanzi. Lekani maphunziro pokhapokha ngati akuwuzani katswiri.

Ndi monotherapy kapena mankhwala ophatikizika "Sitagliptin" okhala ndi Mlingo wa 100 mg amatengedwa pakamwa, mankhwalawo amachepetsa kokha kwa anthu omwe ali ndi vuto la impso.

Njira yayikulu yothetsera kuchotsa mankhwalawa ndi kuchotsa impso. Kwa odwala omwe ali ndi mitundu yayitali komanso yoopsa ya kulephera kwa impso, ndi kulephera kwa aimpso kulephera, ndikofunikira kuchita kukonza - kutanthauza kuchepetsa kuchuluka. Ndi munjira imeneyi pokhapokha magazi omwe ali ndi mphamvu mu plasma azitha kugwira ntchito ngati ali ndi matenda ashuga popanda kuwonongeka kwaimpso.

Zotsatira zoyipa

Zatsimikiziridwa kuti mwayi wokhala ndi hypoglycemia mwa odwala omwe amatenga maphunziro a Sitagliptin samawonjezeka. Kafukufuku wokhudzana ndi kugwirira ntchito limodzi ndi mankhwala osokoneza bongo, omwe zina mwa izi zimaphatikizapo hypoglycemia, sizinachitike.

Mlingo wa odwala omwe ali ofatsa komanso osasintha aimpso sasintha.

Zotsatira zoyipa za mankhwalawa zimatha kugawidwa m'magulu kutengera momwe mthupi lina limakhudzira.

• kupweteka m'mimba
• kusanza ndi kusanza,
• dyspepsia
• kudzimbidwa
• chisangalalo
• kapamba, wokhoza kukhala mitundu yakupha.

• zotupa,
• kutsutsika
• khungu vasculitis
• angioedema.

Zotsatira zina zoyipa:

• chapamwamba kupuma thirakiti matenda
• mutu
• arthralgia,
• myalgia
• bowa wachikopa
• kupweteka kumbuyo
• matenda aimpso.

Pakakhala mankhwala osokoneza bongo, kuyang'anira kuwunika kwa magawo ofunikira a thupi kumafunika. Dokotala akutenga chithandizo chamankhwala, njira zothandizira zikukonzekera, kuphatikizapo hemodialysis.

Mankhwala, pali umboni wowopsa womwe ungakhale chifukwa cha kupweteka kwa pancreatitis monga njira yolakwika yamankhwala. Nthawi zambiri ndimawonekedwe owopsa a hemorrhagic kapena necrotic, omwe amatha kupha. Wodwala matenda ashuga amadziwitsidwa za mawonekedwe a kupweteka kwamatenda a kapamba pofuna kuyitanitsa thandizo kapena kupita kuchipatala. Awa ndi ululu wosapiririka komanso wosapweteka m'mimba. Ngati mukukayikira chiwonetsero cha kapamba, mankhwalawa amachotsedwa mwachangu.

"Sitagliptin" analogues amatengedwa ngati mankhwala:

Analogue yotchuka kwambiri ndi Yanumet. Mtengo wake ndiwokwera kwambiri, pafupifupi ma ruble 2900.

Sitagliptin ndi m'badwo watsopano wamankhwala. Koma si madokotala onse amene amadziwa bwino momwe odwala matenda ashuga a 2 amathandizira. Mpaka posachedwa, chithandizo chachikulu chodziwikiratu chinali Metformin, ndipo tsopano ndizotheka kuti abweretsane ndi monotherapy ndendende ndi Sitagliptin. Ngati mphamvu ya mankhwalawo sikokwanira kuthana ndi shuga, imathandizidwa ndi Metformin kapena mankhwala ena mwakufuna kwa dokotala.

Malinga ndi ndemanga za odwala, lingaliro labwino limapangidwa za mankhwalawa. Zimakhudza kwambiri kuphatikizidwa kwa shuga m'magazi, zimakupatsani mwayi woti musayang'anire mosamalitsa momwe mungatetezere zovuta zoyipa, kuphatikizapo kuvulaza kwambiri kwa hypoglycemia.

Koma pali malingaliro omwe omwe odwala matenda ashuga amadandaula nawo pakuchepa kwa zomwe zakunenedwazo, komanso za kuchepa kwa zotsatirapo pakugwiritsa ntchito nthawi. Izi ndichifukwa choti mtundu wachiwiri wa matenda ashuga ndi matenda osakhazikika omwe amapita patsogolo.

Mutha kugula mankhwalawa muchipatala cha Russia pakukulimbikitsani kwa dokotala. Mtengo wokwanira umachokera ku 1500 - 1700 rubles.

Pomaliza

Kugwiritsira ntchito kwa Sitagliptin endocrinologists muzochita zamankhwala kumathandizira kukulitsa mwayi womwe ungathe kuchitira odwala matenda amtundu wa 2, mosasamala kanthu za gawo la chitukuko. Mankhwalawa akuwonetsa zotsatira zabwino kwa odwala omwe ali ndi prediabetes komanso kwa iwo omwe njira yoyambirira yamankhwala sichinathandizire kukwaniritsa zomwe zinali kuyembekezedwa ndikupanga thanzi komanso thanzi.

Gulu la Nosological (ICD-10)

The International Classization of Diseases of the Tenth Revision (ICD-10) ndi njira yoyesera bwino pankhani yazoyang'anira zaumoyo, zamankhwala, zamatenda, komanso kuwunika momwe anthu alili pachipatala. Malinga ndi ICD-10, mankhwala omwe ali pamapiritsi a Januvia angagwiritsidwe ntchito pa matenda ndi zovuta zotsatirazi:

• E11 Matenda a shuga osadalira insulin (mtundu 2 matenda a shuga).

Othandizira

Omwe amachokera ku Januvia ndi:

• cellcrystalline mapadi,
• sodium croscarmellose,
• calcium hydrogen phosphate,
• sodium yozizira fumarate,
• magnesium wakuba.

• mowa wa polyvinyl
• talcum ufa
• titanium dioxide
• chitsulo
• macrogol (polyethylene glycol) 3350,
• iron oxide ofiira.

Malangizo ogwiritsira ntchito Januvia

Kuwerenga malangizo awa ogwiritsira ntchito mankhwalawa Januvia sikumamasula wodwala kuphunzira "Malangizo ogwiritsira ntchito Januvia", omwe ali pamakatoni opangira makatoni.

Mankhwala a Januvia amawerengedwa malinga ndi malangizo a odwala omwe ali ndi matenda a shuga 2, nthawi zina osakanikirana ndi metformin kapena glitazones, kupepuka mphamvu komanso kudya. Mankhwala ntchito mankhwalawa aimpso ndi chiwindi kulephera. Ndi kuwonjezeka kwa shuga m'magazi, mphamvu ya mankhwalawa imalepheretsa kubisalira kwa glucagon, omwe amalepheretsa kukula kwa hypoglycemia.

Kuchita kwa Januvia kumalimbikitsa kupanga insulin komanso kugwira ntchito kwa maselo a pancreatic beta.

Kukula kwa thupi la wodwalayo sikuchitika mukamamwa mankhwalawo.

Malinga ndi malangizo, nthawi ya mankhwala ndi kuchuluka kwa mapiritsi ndi omwe amatsimikiza ndi endocrinologist. Anthu odwala matenda ashuga amayatsidwa Januvia 100 mg kamodzi patsiku. Pakulephera kwa aimpso, chizolowezi cha tsiku ndi tsiku chimatsika mpaka 50 kapena 25 mg, malingana ndi kuopsa kwa matendawa. Mukaphonya mlingo wotsatira, simuyenera kuwonjezera mlingo wa Januvia.

Januvia iyenera kusungidwa pamalo amdima komanso kuti ana asawatenthe pa kutentha osaposa 30 ° C.

Moyo wa alumali ndi miyezi 24 kuyambira tsiku lomwe mankhwalawo amasulidwa. Tsiku lomaliza litatchulidwa phukusi - musagwiritse ntchito.

Zotsatira zoyipa za Januvia

Januvia amalekeredwa bwino osayambitsa mavuto. Mwapadera, zochitika zotsatirazi zimatha kuchitika.

Kuchokera pakapumidwe:

• Matenda opumira kwambiri a m'mapapo
• Nasopharyngitis.

Kuchokera ku dongosolo lamanjenje lalikulu:

Kuchokera m'mimba:

Kuchokera ku minculoskeletal system:

Kuchokera ku endocrine system:

Contraindication Januvius

Zotsatira za kugwiritsa ntchito mankhwala a Januvia:

• mtundu 1 shuga
• mimba
• matenda ashuga ketoacidosis,
• Nthawi yonyamula mkaka
• kumva kwambiri zigawo za mankhwala.

Zotsatira za mankhwala a Januvia kwa odwala azaka zosaposa 18 sizinaphunzire konse; mapiritsi a Januvia sanalembedwe pagulu la anthu awa.

Mtengo Januvius

Mtengo wa Januvius pamapiritsi sakuphatikiza mtengo wotumizira ngati mankhwalawo agulidwa kudzera pa shopu ya pa intaneti. Mitengo imatha kusiyanasiyana malingana ndi malo omwe mungagule ndi mlingo.

• Russia (Moscow, St. Petersburg) kuyambira 2080 mpaka 3110 ma ruble aku Russia,
• Ukraine (Kiev, Kharkov) kuyambira 686 mpaka 1026 Chiyukireniya h96nias,
• Kazakhstan (Almaty, Temirtau) kuyambira 9797 mpaka 14648 Kazakhstani tenge,
• Belarus (Minsk, Gomel) kuyambira 547040 mpaka 817930 ma Belarusi aku rubles,
• Moldova (Chisinau) kuyambira 582 mpaka 871 Moldovan Lei,
• Kyrgyzstan (Bishkek, Osh) kuyambira 2267 mpaka 3390 Kyrgyz soms,
• Uzbekistan (Tashkent, Samarkand) kuyambira 80662 mpaka 120606 Uzbek soums,
• Azerbaijan (Baku, Ganja) kuyambira 31.0 mpaka 46.3 manats aku Azerbaijan,
• Armenia (Yerevan, Gyumri) kuyambira 14290 mpaka 21366 madera aku Armenia,
• Georgia (Tbilisi, Batumi) kuyambira 70.7 mpaka 105.7 lari aku Georgia,
• Tajikistan (Dushanbe, Khujand) kuyambira 195.9 mpaka 293.0 Tajik somoni,
• Turkmenistan (Ashgabat, Turkmenabat) kuchokera pa 100.5 mpaka 150.2 manats atsopano a Turkmen.

Gulani Januvius

Mutha kugula Januvia mwanjira yokhala mapiritsi okhala ndi mafilimu mumagulu ogulitsa mankhwala osungirako mankhwala, kuphatikiza. Musanagule Januvius ayenera kumveketsa tsiku lotha ntchito. Order Januvia wobereka akhoza kukhala pa intaneti. Mankhwalawa amaperekedwa kokha mwa mankhwala.

Dinani ndikugawana nkhaniyi ndi anzanu:

Wopanga Januvius

Opanga Januvius ndi Merck Sharp & Dohme. Merck Sharp & Dohme ndi malonda omwe kampani ya America Merber & Co imagulitsa malonda padziko lonse lapansi.

Yanumet ndi piritsi yokutidwa ndi filimu, iliyonse yomwe imakhala ndi 50 mg ya sitagliptin, komanso 500, 800 ndi 1000 mg ya metformin, motero kugawa kwa mankhwalawa malinga ndi kuchuluka kwa metformin pakupanga mankhwala. Msika wama pharmacological umapereka mitundu yotsatirayi yotulutsira mankhwala:

• Janumet mapiritsi 500 mg + 50 mg,
• Janumet mapiritsi 800 mg + 50 mg,
• Mapiritsi a Janumet 1000 mg + 50 mg.

Bokosi limodzi limatha kukhala ndi matuza ambiri mpaka asanu ndi awiri. Matumba anayi azithunthu ndiwo akufunika kwambiri. Chithuza chilichonse chimakhala ndi mapiritsi 14. Mutha kusunga mankhwala osaposa zaka ziwiri.

mankhwala okha.

Janumet ndi osayenera kugwiritsa ntchito pamaso pazinthu izi:

• tsankho pazinthu zilizonse zomwe zimapanga mankhwala (povidone, metformin, sitagliptin phosphate monohydrate, stearyl fumarate ndi sodium lauryl sulfate),
• kuzindikira mtundu 1 shuga
• magawo akulu a matenda osiyanasiyana a impso, komanso vuto la pachimake pakufalitsa matenda kapena kuwopseza (kuchepa madzi m'thupi), kukhudza ntchito ya impso.
• uchidakwa kapena uchidakwa.
• nthawi ya pakati (nthawi ya bere, komanso nthawi yoyamwitsa), maphunziro a radiology (mwachindunji sabata limodzi pambuyo ndi njirayi),
• kukhalapo kwa matenda, makamaka omwe amalumikizana ndi mtima dongosolo, zomwe zimayambitsa kuperewera kwa mpweya wa minofu ya minofu.

Kuwonetsetsa makamaka mutatenga Yanumet kuyenera kuperekedwa kwa anthu achikulire. Zowonadi, pakupita nthawi, kugwira ntchito kwa impso kumachepa, ndipo iwo ali ngati mawonekedwe a thupi la munthu. Ndi m'badwo, dongosolo la ma excretory dongosolo, zomwe zikutanthauza kuti likuvutikira kuchotsa zinthu zosafunikira ndi zinthu zina mthupi. Popereka Yanumet kwa anthu okalamba, akatswiri ayenera kusankha bwino mankhwalawa, komanso kuyang'anira wodwala nthawi zonse.

Mankhwalawa amaletsedwa kwa ana osakwana zaka 18.

Yanumet, monga mankhwala ena aliwonse omwe ali ndi mphamvu, ali ndi zovuta zingapo zomwe zingachitike wodwala pakapita nthawi kapenanso atangomaliza kumene.Mankhwalawa amakhudza kwambiri m'mimba, amathandizira kuchepa kwa thupi pang'onopang'ono (mpaka anorexia), komanso mtima wamtima. Kuphwanya kwa chizolowezi cha kagayidwe sikumaphatikizidwa, kuphatikiza apo, matupi awo sagwirizana pakhungu amapezeka - osiyanasiyana totupa ndi kuyabwa.

Izi ndi zotsatira zoyipa zomwe zimayambitsidwa chifukwa cha kumwa mankhwalawa:

• kupweteka kwakanthawi m'mutu kapena kosalekeza, koma kufooka kwapang'onopang'ono, kuchepa kwa ntchito ndi mphamvu yogwira thupi, nthawi zina kugona mosafunikira ndi kutopa kosalekeza kumadziwika,
• zilonda zapakhosi, mpaka pakuwoneka ngati kutsokomola kosasangalatsa.
• pakamwa mokhazikika, ngakhale mutamwa madzi (nthawi zambiri amatsatana ndi chifuwa), pakudya nthawi yayitali, pamakhala kusokonezeka komwe kumagwira ntchito pamimba.

Chimodzi mwazina mwazizindikirozi mwapezeka mukumwa mapiritsiwo, muyenera kufotokozera dokotala za zoyipa zanu. Kutengera pakuwunika ndi kusanthula, katswiri angathe kusankha chithandizo choyenera kwambiri pamilandu inayake. Kupatula apo, Yanumet siwokhawo mankhwala omwe angakuthandizeni kulimbana ndi matendawa.

Janumet ndi mankhwala odula, mtengo wake umasiyanasiyana ma ruble 2700 mpaka 3000,000 phukusi lokhala ndi matuza anayi. Komanso, mtengo wake umatha kumasiyanasiyana malinga ndi mtundu wa zotulutsidwa (kuchuluka kwa mapiritsi, kuchuluka kwa metformin) ndi malo ogulira. Chifukwa chake, m'masitolo otsogola pa intaneti, kuyika kwa Yanumet kumawononga ndalama kuchokera ku 2700 mpaka 2800 rubles kupatula kutumiza (kwa mapiritsi 56). Koma pamankhwala okhala pamaneti a Yanumet mutha kupereka ma ruble 3,000,000.

Kuphatikizika kwapadera komwe kumaphatikiza metformin ndi sitagliptin kumapangitsa kuti mankhwalawa akhale osiyanasiyana pamsika wamankhwala. Kupatula apo, Yanumet ndiye mankhwala okhawo omwe amaphatikiza zinthu ziwiri izi. Koma mtengo wokwera kwambiri umatipangitsa kuti tipeze mankhwala ena othandizira koma okwera mtengo.

Mankhwala a Velmetia ali ndi mawonekedwe ofanana, koma mtengo wa mankhwalawa siosiyana kwambiri ndi mtengo wa Yanumet. Palibe mankhwala pamtengo wa chidutswa chomwe chimakhudza thupi la odwala omwe ali ndi matenda ashuga a 2 monga Yanumet, koma mutha kuyesa kutenga mankhwala angapo limodzi kuti mukwaniritse bwino kwambiri kukhala ndi shuga.

Mankhwalawa akuphatikizapo:

• Metformin woyenga (metformin) ndi sitagliptin (Januvia). Metformin imawononga ndalama pafupifupi ma ruble 250 ndi zidutswa 60, ndipo Januvius 1500 mapiritsi 28. Ndalamazi ziyenera kutengedwa palimodzi kuti zitheke zotsatira zabwino,
• Galvus (ma ruble 800 a mapiritsi 28) ndi Glyukofazh (ma ruble 350 ndi mapiritsi 60) onse. Mankhwalawa amathandizana wina ndi mnzake, koma amasiyana ndi Yanumet poganizira kwambiri kuthetsa mavuto omwe amabwera chifukwa cha mtima wamtundu wa shuga,
• Glibomet. Mankhwalawa ali ndi metformin ndi glibenclamide ndipo ali ndi zofanana ndendende ndi Janumet. Cholinga chake ndi kuthana ndi hypoglycemia, ili ndi milomo yotsitsa lipid. Pafupifupi, mtengo wa mankhwalawa ndi ma ruble 350 pamapiritsi 40,
• Avandamet samapezeka kawirikawiri m'mafakitala aku Russia; mtengo wake ndi ma ruble 400 pamapiritsi 60 aliwonse. Ili ndi 500 mg ya metformin ndipo singagwiritsidwe ntchito ngati chida chothandiza popanda mankhwala ovuta. Ichi ndichifukwa chake mankhwalawa ndi otsika kwambiri ku Yanumet, ngakhale amagwira bwino ntchito ndi chithandizo chovuta,
• Tripride imakhala ndi zofanana ndi Yanumet, koma yotsika poyerekeza ndi kuchuluka kwa zinthu zomwe zili momwemo (imakhala ndi glimepiride ndi pioglitazone). Mankhwala oterowo amatenga pafupifupi ma ruble mazana awiri piritsi (30 mapiritsi) ndipo ndi analogue yotsika mtengo kuposa onse omwe aperekedwa,
• Douglimax amaphatikiza metformin ndi glimepiride, komanso ali ndi mfundo zofananira ndi mapiritsi oyambira, koma kuchepa kwa shuga m'magazi kumakhala kotsika kwambiri kwa iwo. Douglimax imawononga ndalama pafupifupi ma ruble a 350 phukusi lomwe lili ndi miyala 30.

Chofunikira kukumbukira ndikuti kusintha kwina kulikonse ndi mankhwala kuyenera kuvomerezeredwa ndi dokotala, apo ayi zingayambitse zotsatira zosakonzekera. Kudziyimira pawokha pakuthandizira matenda oopsa ngati awa sikuvomerezeka, chifukwa izi zitha kupangitsa kuti magazi azikhala ochepa komanso kuti magazi achepetse magazi.

The zikuchokera ndi zomwe mankhwala

Mankhwala a Januvia ali ndi chopangira chachikulu - sitagliptin phosphate monohydrate. Mankhwalawa amapangidwa pogwiritsa ntchito zokomera:

1. Croscarmellose sodium
2. Calcium calcium hydrogen phosphate, wosadzaza,
3. MCC
4. Sodium silyl fumarate.

Mapiritsi a achinyamata a shuga ali ndi zokutira zamafuta zomwe zimapangidwa kuchokera ku titanium dioxide, utoto wachikasu wachitsulo, polyvinyl mowa utoto wa iron oxide ofiira, talc, macrogol.

Januvia ndi mankhwala otsika mtengo a matenda ashuga, choletsa kusankha kwambiri kwa puleptidyl peptidase enzyme. Mutatha kumwa mankhwalawa, kuwonjezeka kwa kuchuluka kwa mahomoni awiri a insretins kumawonedwa. Chifukwa cha mankhwalawa, pali katulutsidwe wamahomoni m'matumbo, kuwonjezeka kwa kupanga kwawo pakudya. Kuchita kwa mahomoni cholinga chake pakupanga kupanga insulin.