Tsoka ilo, sizotheka nthawi zonse kuwongolera kuchuluka kwa shuga ndi masewera olimbitsa thupi ndi zakudya zoyenera. Ndiye muyenera kugwiritsa, mwachitsanzo, Galvus, analogues zapakhomo, mtengo wake womwe ndi wotsika kwambiri kuposa mankhwala omwe amalowetsedwa kunja, omwe amalumikizidwa ndikuchepetsa mtengo wa mayendedwe, inshuwaransi, ma CD.
Chifukwa cha mtengo wake wokwera, nthawi zambiri odwala omwe ali ndi ndalama zochepa komanso zapakati amasinthira kuchipatala ndi analogues. Koma ndi bwino kusankha? Izi zidzafotokozedwanso, koma choyambirira, muyenera kuzolowera mankhwala a Galvus.
Gawo logwira ntchito la hypoglycemic wothandizira ndi vildagliptinum, koma pali zosankha zophatikiza ndi metformin. Pogula mankhwala ku malo ogulitsa mankhwala, wopanga mankhwalawa amapereka mitundu yambiri - 50 mg, komanso kuphatikiza ndi metformin 50/500 mg, 50/8 mg ndi 50/1000 mg.
Vildagliptin ndi gulu la zinthu zomwe zimasintha magwiridwe antchito a alpha ndi beta cell omwe amapanga timabungwe ta Langerhans mu kapamba ndikulepheretsa zochita za dipeptidyl peptidase-4. Ma enzyme amenewa amawononga mtundu wa glucagon ngati 1 peptide (GLP-1) ndi insulinotropic polypeptide (HIP) ya glucose.
Zotsatira za mankhwala
Chifukwa cha vildagliptin, zovuta zoyipa za dipeptidyl peptidase-4 zimachepetsedwa, ndipo kupanga kwa GLP-1 ndi HIP, m'malo mwake, kumalimbikitsidwa. Mlingo wa zinthuzi m'magazi utakwera, vildagliptin imasintha chiwopsezo cha maselo a beta ku glucose opangidwa, potero imathandizira kupanga mahomoni ochepetsa shuga. Tizikumbukira kuti phindu lothandizira magwiridwe antchito a maselo a beta zimatengera mulingo wowonongera. Chifukwa chake, mwa anthu omwe ali ndi shuga omwe ali ndi shuga, vildagliptin sichikhudzanso kupanga kwa insulin, komanso, kupanga shuga.
Gawo lothandizirali limachulukitsa kuchuluka kwa GLP-1 ndipo nthawi yomweyo limakulitsa chidwi cha maselo a alpha a pulogalamu ya islet. Zotsatira zake, kupanga kwa glucagon kumawonjezeka. Kutsika kwa kuchuluka kwake pakudya kumadzetsa chidwi cha zotumphukira zama cell kuzinthu zamagetsi zomwe zimachepetsa shuga.
Pakukwera msanga kwamisempha, glucagon ndi insulin zimachulukana, zomwe zimadalira mwachindunji pakupanga kwa GLP-1 ndi HIP, ndipo njira yopanga shuga m'magazi imatsika pang'onopang'ono panthawi ya chakudya komanso pambuyo pake, yomwe imayambitsa kuchepa kwa kuchuluka kwa shuga m'magazi. Dziwani kuti kungokhala kokhazikika kwa GLP-1 kumachepetsa mayendedwe am'mimba, ngakhale muzochita sizinapangitse kuti izi zichitike.
Kugwiritsa ntchito kwazinthu ziwiri zazikulu kwambiri - metformin ndi vildagliptin, kuwongolera bwino kuchuluka kwa matenda a diabetes kwa maola 24.
Malangizo ogwiritsira ntchito mapiritsi
Kudya sikukhudzana ndi kugwiritsa ntchito mankhwalawa Galvus kapena Galvus Met.
Musanagwiritse ntchito mankhwalawa, ndikofunikira kufunafuna thandizo la katswiri yemwe angadziwe payekha.
Mu malangizo omwe ali pompopompo a Galvet 50 mg, mankhwalawa akuwonetsa kuti angasinthe ndi madokotala omwe akupezekapo:
- Ndi monotherapy kapena kuphatikiza ndi insulin, thiazolidinedione, metformin - 50-100 mg.
- Omwe ali ndi mtundu wotsogola kwambiri amatenga 100 mg pa tsiku.
- Kulandila kwa vildagliptin, zochokera ku sulfonylurea ndi metformin - 100 mg patsiku.
- Kugwiritsa ntchito kosavuta kwa sulfonylurea ndi Galiv zimatengera mlingo wa 50 mg patsiku.
- Ngati munthu wodwala matenda ashuga ali ndi vuto lochepa kwambiri komanso laimpso, tsiku lililonse ndi 50 mg.
Cholembedwachi chili ndi chidziwitso chakuti mlingo wa 50 mg uyenera kumwa nthawi imodzi, ndipo 100 mg igawidwe pawiri - m'mawa ndi madzulo.
Mlingo wa mankhwala a Galvus Met amatsimikizidwanso ndi dokotala, poganizira kuchuluka kwa shuga ndi kulolerana kwa zigawo za mankhwala kwa wodwala. Bukuli likuwonetsa mlingo wapakati:
- osagwiritsa ntchito vildagliptin, ndikulimbikitsidwa kutenga 50/500 mg kawiri patsiku;
- ngati kugwiritsa ntchito metformin sikuthandiza, tengani 50/500 mg, 50/8 mg kapena 50/1000 mg kawiri patsiku, kutengera metformin yomwe idagwiritsidwa ntchito kale;
- kuphatikiza kosakwanira kwa vildagliptin ndi metformin, 50/500 mg, 50/8 mg kapena 50/1000 mg kawiri pa tsiku kumagwiritsidwa ntchito, kutengera magawo omwe amagwiritsidwa ntchito;
- Pa mankhwala oyamba ndi mankhwalawa chifukwa chosakwanira pakudya ndi masewera olimbitsa thupi, imwani 50/500 mg kamodzi patsiku;
- kuphatikiza ndi insulin mankhwala ndi zotumphukira za sulfonylurea, mlingo wa vildagliptin ndi 50 mg kawiri patsiku, ndipo metformin imakhala yofanana ndi monotherapy.
Kugwiritsa ntchito mankhwalawa ndizoletsedwa kwa odwala matenda ashuga omwe amayamba chifukwa cha kulephera kwa impso ndi zina zomwe zimayambitsa ziwalo. Kuphatikiza apo, chisamaliro chapadera chimaperekedwa kwa odwala omwe ali ndi zaka zapamwamba (zopitilira 65), chifukwa nthawi zambiri amakhala ndi kuchepa kwa impso.
Dokotala amatha kuwonjezera kuchuluka kwa mankhwalawa, komabe, ndizoletsedwa kuchitira nokha chithandizo, izi zingayambitse zotsatira zoyipa komanso zosasinthika.
Contraindication ndi zomwe zingavulaze
Mankhwalawa ali ndi zotsutsana zambiri, komanso mankhwala ena.
Kwenikweni, ma contraindication amaphatikizidwa ndi kuthekera kwa ziwalo zina za anthu kuchotsa zinthu zomwe zikugwira mthupi.
Sizoletsedwa kugwiritsa ntchito njira za Galvus ndi Galvus Met kwa odwala matenda ashuga kapena omwe akudwala matenda ena:
- Kulephera kwamkati kapena kulephera kwa impso (zolengedwa za creatinine ndizoposa 135 μmol / L mwaimuna, zoposa 110 μmol / L mwa akazi).
- Pathologies omwe amawonjezera mwayi wokhala ndi vuto la impso. Izi zimaphatikizira kuchepa kwa madzi m'thupi (kusanza kapena kutsegula m'mimba), kutentha thupi, matenda, komanso kuchepa thupi.
- Kuchepa kwa chiwindi.
- Kukhazikika kwa lactic acidosis.
- Kukula kwa kupuma kulephera.
- Kukula kwa mtima kulephera pachimake ndi mawonekedwe, komanso pachimake myocardial infarction.
- Metabolic acidosis, kuphatikizapo isanayambike ketoacidosis, chikomokere, precoma.
- Panthawi yobereka mwana ndi kuyamwitsa.
- Matenda a shuga a insulin.
- Opaleshoni.
- Simungagwiritse ntchito mankhwalawa masiku awiri isanachitike komanso mutatha mayeso a radiology ndi radioisotope ndikuyambitsa gawo lomwe lili ndi ayodini.
- Kumwa mowa ndi mawonekedwe ake.
- Zakudya zama calori zochepa (zosakwana 1000 kcal patsiku).
- Osakwana zaka 18.
- Kusalolera payekha kwa vildagliptin, metformin ndi zida zina.
Ngati mankhwalawa agwiritsidwa ntchito molakwika kapena pazifukwa zoposa zomwe wodwala angagwiritse ntchito, zotsatirapo zoyipa zingachitike, mwachitsanzo:
- kupweteka mutu komanso chizungulire;
- pachangu minofu contraction (kugwedeza) ndi kuzizira;
- gastroesophageal Reflux;
- kupumirana mseru ndi kusanza;
- kutsegula m'mimba kapena kudzimbidwa;
- kuchuluka kwa mpweya m'matumbo;
- kusintha kukoma
- hypoglycemia;
- kutopa;
- hyperhidrosis;
- totupa pakhungu, kuyabwa, urticaria;
- zotumphukira kufalikira;
- arthralgia (kupweteka kolowa);
- kutuluka kwa khungu;
- mawonekedwe a matuza;
- lactic acidosis;
- kusowa kwa vitamini B12;
- kapamba
Kuphatikiza apo, matenda a chiwindi amatha kupezeka mthupi.
Mtengo, kuwunika ndi kutanthauzira
Wopanga mankhwalawa ndi kampani yaku Swiss pharmacological ku Novartis, yomwe imapanga mankhwala okhala ndi vildagliptin kapena kuphatikiza kwa vildagliptin ndi metformin.
Mankhwala osokoneza bongo amatha kuyitanidwa pa intaneti kapena ingopita ku pharmacy yapafupi. Mtengo wa mankhwala umatengera mawonekedwe ake. Mtengo wake ndi motere:
- Galvus 50 mg (mapiritsi 28) - ma ruble 765.
- Galvus Met 50/500 mg (mapiritsi 30) - 1298 ma ruble.
- Galvus Met 50/850 mg (mapiritsi 30) - 1380 ma ruble.
- Galvus Met 50/1000 mg (mapiritsi 30) - 1398 ma ruble.
Monga mukuwonera, mankhwalawa siotsika mtengo kwenikweni. Sikuti aliyense azitha kulandira mankhwala okhazikika ndi mankhwalawa, chifukwa chake pali zofunika kusankha mankhwalawa, omwe tikambirane pambuyo pake.
Ponena za lingaliro lamankhwala Galvus, ali ndi chiyembekezo. Ndemanga ya ambiri omwe amamwa mankhwalawa akuwonetsa kuti pambuyo pa miyezi 1-2 atamwa Galvus, zizindikiro za glucose zimabwezeretsa. Kuphatikiza apo, odwala matenda ashuga monga momwe mumagwiritsira ntchito mankhwalawa mutha kudya zakudya zoletsedwa kale. Galvus Met, chifukwa cha metformin yake, imathandiza kutaya mapaundi owonjezera a 3-4 kwa odwala omwe ali ndi kunenepa kwambiri. Komabe, mankhwalawa ali ndi vuto limodzi lalikulu - ndizokwera mtengo kwake.
Ngati wodwala akuletsedwa kugwiritsa ntchito Galvus chifukwa cha contraindication kapena chifukwa cha mbali, dokotala amamulembera mankhwala ena. Izi zimatha kukhala zofananira, ndiye kuti, zinthu zomwe zimakhala ndi zinthu zomwezo, kusiyana kumangokhala pazowonjezera. Galvus Met ndiye chimodzimodzi ndi Galvus; izi ndi zokonzekera ziwiri zomwe zili ndi vildagliptin.
Komabe, mankhwalawa ali ndi mankhwala ambiri ofanana omwe ali ndi zofanana zochizira, zomwe tidzakambirana pambuyo pake.
Mndandanda wa mankhwala Galvus
Gulu la mankhwalawa limaphatikizanso yogwira - vildagliptin. Izi zikuphatikiza ndalama za Vipidia, Onglisa, Januvius ndi Trazent. Ku Russia, zokonzekera zomwe zili ndi vildagliptin sizipangidwa, chifukwa chake tikambirana za mankhwala omwe atengedwa kunja.
Vipidia ndi mankhwala ochepetsa shuga omwe amapangidwira monotherapy kapena chithandizo cha mitundu yachiwiri ya matenda ashuga. Amatulutsidwa mu mawonekedwe a piritsi, mlingo wapamwamba kwambiri watsiku ndi tsiku ndi 25 mg ndipo sizitengera chakudyacho. Wothandizila hypoglycemic sangatengedwe ndi anthu odwala matenda ashuga a impso, hepatic, mtima kulephera, ndi matenda ashuga a ketoacidosis komanso mtundu wa matenda a shuga. Zotsatira zoyipa ndizofanana ndi zoyipa zomwe zimachitika chifukwa cha Galvus. Chifukwa cha kusowa kwa zambiri pazamankhwala omwe amapezeka ndi ana osakwana zaka 18 ndi amayi apakati, sizinafotokozeredwe magulu amtundu wa odwala. Mtengo wapakati wa Vipidia (mapiritsi 25 mg 28) ndi ma ruble 1239.
Onglisa ndi kukonzekera bwino kukhalabe ndi shuga wamagazi pamimba yopanda kanthu ndikatha kudya. Chifukwa cha saxagliptin yayikulu, mankhwalawo amawongolera zomwe zili ndi glucagon. Itha kugwiritsidwa ntchito ngati chuma chokhazikika komanso kuphatikiza ndi mankhwala ena. Mankhwala a Onglis amaphatikizidwa ndi insulin, mtundu wa 1 shuga ndi ketoacidosis. Zotsatira zoyipa zoyipa kwambiri ndi mutu, kutupa, zilonda zapakhosi. Mtengo wapakati wa mankhwalawa (mapiritsi a 5 mg 30) ndi 1936 rubles.
Januvia ndi othandizira a hypoglycemic, omwe amaphatikiza yogwira mtima sitagliptin. Kugwiritsa ntchito mankhwalawa kumathandizira kukula kwa glycemia ndi glucagon. Mlingo umakhazikitsidwa ndi adokotala, omwe amawaganizira shuga, thanzi ndi zina zambiri. Mankhwala a Januvia amaphatikizidwa chifukwa cha matenda a shuga omwe amadalira insulin komanso kusalolera payekhapayekha ziwalo zake. Pa nthawi yogwiritsira ntchito, kupweteka mutu, kugaya chakudya, kupweteka kwamkati, komanso kupuma kumatha kuchitika. Pafupifupi, mtengo wamankhwala (mapiritsi 100 mg 28) ndi ma ruble 1666.
Trazhenta ndi mankhwala omwe amapangidwa mwanjira ya mapiritsi okhala ndi lignagliptin yogwira mankhwala. Imafooketsa gluconeogeneis ndipo imakhazikitsa shuga. Dokotala amasankha payekha payekha kwa wodwala aliyense.
Sitha kugwiritsidwa ntchito ketoacidosis, mtundu 1 wa shuga ndi tsankho la zinthu zomwe zili. Mtengo wapakati (mapiritsi a 5 mg 30) ndi ma ruble 1769.
Analogs a Gal Gal Met
Kwa mankhwala a Galvus Met, ma analogu ndi Avandamet, Glimecomb, Combogliz Prolong of Russia, omwe ali ndi zinthu ziwiri zazikulu zothandiza kuchepetsa shuga.
Avandamet ndi othandizira a hypoglycemic okhala ndi zigawo zikuluzikulu ziwiri - rosiglitazone ndi metformin. Mankhwalawa amagwiritsidwa ntchito pochiza matenda osokoneza bongo omwe amadalira shuga. Kuchita kwa rosiglitazone cholinga chake ndikukulitsa chidwi cha ma cell receptors kuti apange insulin, ndi metformin - pakuchepetsa kufalikira kwa chiwindi ndi chiwindi. Mtengo wapakati wa mankhwalawa (mapiritsi a 500/25 mg 56) ndi ma ruble 210, ndiye kuti analogue yotsika mtengo.
Glimecomb ndi mankhwala ena othandiza omwe amachititsa kuti shuga azikhala ndi matenda ashuga. Muli zinthu ziwiri zazikulu - gliclazide ndi metformin. Contraindication pakugwiritsa ntchito mankhwalawa ndimatenda omwe amadalira insulin, chikomokere ndi khansa, hypoglycemia, kutenga pakati, kuyamwitsa ndi ma pathologies ena. Mtengo wamba (40/500 mg 60 mapiritsi) ndi ma ruble 440.
Combogliz Prolong imaphatikizapo zinthu zofunika monga metformin ndi saxagliptin. Amagwiritsidwa ntchito pa matenda a shuga a 2, pamene zochitika zolimbitsa thupi komanso zakudya zapadera sizingathe kupereka kuchepa kwa shuga. Mankhwalawa amathandizira kuti insulini imasulidwe m'maselo a beta komanso imapangitsa kuti maselo azitha kugwira ntchito. Contraindication pa kugwiritsa ntchito mankhwalawa ndi chidwi cha munthu ndi zinthu za mankhwala, shuga Mtengo wapakati wa mankhwalawa (mapiritsi a 1000/5 mg 28) ndi ma ruble 2941.
Kutengera ndi contraindication, kuvulaza komwe kungakhalepo komanso mtengo wokwera wa mankhwalawo, amatha kusinthidwa ndi wina. Monga mukuwonera, mankhwala omwe ali munkhanowu ndi okwera mtengo pafupifupi. Pakati pawo, ma analogu awiri amatha kusiyanitsidwa - Glimecomb ndi Avandamet, omwe ndi otsika mtengo kwambiri pakati pa mankhwala ena a hypoglycemic. Mukamasankha njira yabwino kwambiri, dokotala komanso wodwalayo amaganizira zinthu ziwiri zofunika kwambiri - mtengo wake komanso chithandizo cha mankhwalawo.
Zambiri pazamankhwala othandizira kwambiri a shuga amaperekedwa mu kanema munkhaniyi.
