Kusiyana kwakukulu pakati pa Victoza ndi kusakhalapo kwathunthu kwa ma fanizo pamsika wamankhwala, womwe umakhudza mfundo zamitengo ya mankhwala otere.
Mankhwalawa amathandizira kuchepetsa ndikusintha shuga m'magazi, koma apezeka kuti ndi mankhwala othandizanso kunenepa kwambiri.
Kodi chithandizo chovuta kwambiri cha matenda am'thupi ndi chiti?
Mellitus wosadalira insulin ndi matenda amtundu wa endocrine pomwe maselo amthupi amakana insulini yopangidwa ndi kapamba.
Zotsatira zake, maselo amalephera kumva kukoma kwa timadzi tam'magazi, glucose sangathe kulowa mu minofu, kudzikundikira m'thupi. Nawonso, kuwonjezeka kwamankhwala a insulin kumawonekeranso, chifukwa kapamba amayamba kupanga kuchuluka kwa timadzi timeneti.
Pakukonzekera kwa pathological process, pali kuphwanya njira zonse za metabolic mthupi, ziwalo zambiri zamkati ndi kachitidwe zimavutika.
Njira zamakono zochizira matenda zimatengera mfundo izi:
- Kutsatira zakudya. Kusankhidwa kwamankhwala ndi zakudya zomwe sizingagwiritsidwe ntchito sizingothandiza kuchepetsa kuchuluka kwa shuga, komanso zimathandizira kuchepetsa kunenepa. Monga mukudziwira, chimodzi mwazinthu zomwe zimapangitsa kuti odwala asakhale ndi insulin omwe amadalira shuga ndi kunenepa kwambiri.
- Thupi lathupi limathandizanso kuchepetsa shuga la magazi. Nthawi zina zimakhala zokwanira kukhala ndi moyo wakhama, kuyenda tsiku lililonse ndi mpweya wabwino, kuti wodwalayo amva bwino.
- Mankhwala. Kubwezeretsanso shuga kunthawi zonse kumathandizanso mankhwala oyenera adokotala.
Mpaka pano, chithandizo cha matenda osokoneza bongo omwe amadalira shuga
- mankhwala omwe amachokera ku sulfonylurea. The pharmacological tingati kulimbikitsa katulutsidwe wa amkati insulin;
- mankhwala omwe amaphatikizidwa ndi gulu la Biguanides. Zotsatira zawo cholinga chake ndikuchepetsa kufunikira kwa insulin katulutsidwe;
- mankhwala omwe amachokera ku thiazolidinol amathandiza kuchepetsa shuga wamagazi ndipo amathandizanso kusintha kwa mawonekedwe a lipid;
- ma insretins.
Ngati mankhwala omwe ali pamwambapa omwe amachepetsa shuga ya magazi samabweretsa zabwino, mankhwala a insulin angagwiritsidwe ntchito.
Chachikulu pharmacological zotsatira za mankhwala
Mankhwala Victoza, monga lamulo, amawerengedwa kwa odwala omwe ali ndi matenda osokoneza bongo omwe amadalira shuga, monga mankhwala othandizira othandizira. Njira yochiritsira yogwiritsa ntchito mankhwalawa imayenera kutsatiridwa ndi zakudya zapadera komanso kuchita masewera olimbitsa thupi. Pokhapokha ngati mutachita izi, mutha kukwaniritsa zotsatira zabwino za mankhwalawa.
Mankhwala a Victoza amapangidwa ndi opanga mwa njira yothetsera jakisoni wa subcutaneous. M'mapiritsi ndi mitundu ina ya mankhwala, mankhwalawa saperekedwa mpaka pano.
Mankhwala Victoza ndi analogue wa glucagon-ngati peptide-imodzi ya munthu, yopangidwa ndi njira yachilengedwe, ndipo 90% ikugwirizana nayo. Thupi limangirira ku ma receptor ena omwe amayang'aniridwa ndi ma insretin opangidwa ndi thupi. Nawonso, incretin ya mahomoni imapangitsa kuti inshuwaransi ipangidwe.
Zotsatira za mankhwalawa zimathandizanso kuchepetsa kupanga kwa insulin ngati mkhalidwe wa hypoglycemia umawonedwa. Chifukwa chake, kuchepa kwa thupi ndi kusintha kwa matendawa kumachitika, kuchuluka kwa mafuta kumatsika, ndikukula kwambiri kumatha.
Mankhwalawa amapezeka ngati syringe cholembera Victoza voliyumu itatu. Chofunikira chachikulu pa mankhwalawa ndi liraglutide. Mankhwalawa amalowetsedwa mkati mwa maola asanu ndi atatu mpaka khumi ndi awiri, ndipo pokhapokha ngati nthawi imeneyi amatha kukhala m'magazi ambiri.
Chingoni cha Victoza cha syringe chimagulitsidwa makatoni apadera amtundu umodzi, jakisoni awiri kapena atatu. Kuphatikiza apo, ilinso ndi malangizo a boma ogwiritsira ntchito mankhwala omwe ali ndi zotsatirazi:
- Upangiri wotsatira wa momwe mungakhazikitsire Victoza.
- Mlingo woyenera.
- Kugwiritsa ntchito singano moyenera.
- Zotsatira zoyipa ndi contraindication.
Ma CD ndi ma singano amaikidwa mu katoni kapadera kagalasi, kameneka ndi cholembera chosokonekera. Syringe iliyonse ndi yokwanira milingo makumi atatu a 0,6 mg. Ngati dokotala atapereka chithandizo chachikulu kwa wodwala, kuchuluka kwa jakisoni kumachepetsedwa. Jakisoni amachitidwa mosavuta, chinthu chachikulu ndikupeza maluso ena kuti muthane ndi singano pansi pa khungu.
Zizindikiro zazikulu za jekeseni wa mtundu wachiwiri wa shuga wokhudzana ndi mankhwalawa ndi motere:
- ngati mankhwala main
- pamodzi ndi mankhwala ena - Metformin, Glibenclamide, Dibetolongол
- ntchito ndi insulin mankhwala.
Kuphatikiza apo, mankhwalawa amatha kuperekedwa kwa odwala matenda a shuga ngati mankhwala ochepetsa thupi. Maganizo a wodwala a Victoza akuwonetsa kuti mukamamwa mankhwalawa, kuchepa kwamatenda kumayang'aniridwa, kuchuluka kwa shuga m'magazi kumatulutsa.
Kuphatikiza apo, jekeseni wokhazikika kwa mwezi kumathandizira kuchepetsa kuchuluka kwa triglycerides.
Malangizo ogwiritsira ntchito mankhwalawa
Malangizo a Victoza ogwiritsira ntchito akuti kuyambika kwa mankhwalawa kuyenera kuchitika ndi Mlingo wotsika kwambiri wa mankhwalawa. Chifukwa chake, kuyang'anira kwa metabolic kofunikira kumaperekedwa.
Mukamamwa mankhwalawa, wodwalayo ayenera kuyang'anira kuchuluka kwa shuga m'magazi. Mankhwala omwe amapezeka, komanso kuchuluka kwa kuchuluka kwa jekeseni, amadziwika ndi dokotala wokha. Pankhaniyi, kudzipereka palokha ndi koletsedwa.
Mankhwala Viktoza amaperekedwa kamodzi patsiku, popeza zochita za liraglutide zimayamba kuchitika patapita nthawi.
Jakisoni wa Victoza amayenera kuperekedwa pansi pa khungu pamalo amodzi osavuta:
- Mapewa.
- Thu.
- Belly
Poterepa, jakisoni wa singano samatengera chakudya chachikulu. Monga lingaliro, zimawonedwa kuti ndizoyenera kusunga nthawi yomweyo pakati pa jakisoni. Tiyenera kudziwa kuti mankhwala a Viktoza saloledwa kulowa kudzera m'mitsempha kapena intramuscularly.
Kuchuluka kwa Mlingo woyenera kumadalira kukula kwa kuchuluka kwa matendawo ndi mikhalidwe ya wodwalayo. M'magawo oyamba a chithandizo chamankhwala, tikulimbikitsidwa kupaka jekeseni kamodzi patsiku, womwe udzakhale 0,6 mg wa liraglutide. Osati kale sabata limodzi chiyambireni kuyambika kwa mankhwala, kuwonjezeka kwa Mlingo mpaka 1,2 mg wa mankhwala patsiku ndikuloledwa. Kukula kulikonse kwa mankhwalawa kuyenera kuchitika ndi masiku osachepera asanu ndi awiri.
Kuchuluka kwa liraglutide woperekedwa sikuyenera kupitirira 1.8 mg.
Nthawi zambiri pamankhwala ovuta, mankhwala amagwiritsidwa ntchito molumikizana ndi Metformin kapena mankhwala ena ochepetsa shuga. Pankhaniyi, Mlingo wa mankhwalawa umatsimikiziridwa ndi adokotala.
Malinga ndi machitidwe azachipatala, pakuthandizira kwa matenda okalamba mu okalamba, mulingo woperekedwa wa mankhwalawo sunasiyane ndi omwe alembedwa pamwambapa.
Ndemanga za Victoza za akatswiri azachipatala amawirikiza poti kugwiritsa ntchito mankhwalawa kuyenera kuchitika pokhapokha ngati akuwuzidwa ndi adokotala. Pankhaniyi, mutha kupewa kuwoneka ndi mavuto ndikusankha mulingo woyenera.
Ndikofunika kusunga mankhwalawo mufiriji pa kutentha kwa madigiri awiri mpaka asanu ndi atatu.
Amaloledwa kusiya mankhwalawo m'malo omwe kuwala kwa dzuwa sikulowa, bola kutentha sikupitirira madigiri sate.
Ndi ziti zotsutsana zomwe zimagwiritsidwa ntchito?
Monga mankhwala ena aliwonse, Victoza ali ndi zotsutsana zingapo kuti agwiritse ntchito.
Ma contraindication onse omwe akupezeka amawonetsedwa mu malangizo ogwiritsira ntchito mankhwalawa.
Ndi achire njira yochizira ndi Victoza, zotsutsana zonse zomwe zingagwiritsidwe ntchito ziyenera kukumbukiridwa.
Liraglutide sayenera kugwiritsidwa ntchito pazotsatirazi:
- Hypersensitivity gawo limodzi kapena zingapo za mankhwalawa
- odwala omwe akudwala matenda a shuga a mtundu wa insulin
- ngati wodwala ali ndi matenda ashuga a ketoacidosisꓼ
- mavuto ndi yachibadwa ntchito impso
- vuto pamavuto a chiwindiꓼ
- ngati maluso a genitourinary systemꓼ
- ngati pali matenda amitsempha yama mtima, kukhumudwa mtima
- kukula kwa njira yotupa m'matumbo, komanso matenda ena a ziwalo zam'mimba thirakiti (kuphatikizapo paresis yam'mimba) ꓼ
- ana ochepera zaka khumi ndi zisanu ndi zitatu ndi odwala atatha zaka makumi asanu ndi awiri ndi zisanuꓼ
- atsikana pa nthawi yoyembekezera komanso mkaka wa m'mawere.
Kafukufuku wazachipatala awonetsa kuti ndizovomerezeka kuti azimayi amwe mankhwala pa nthawi yomwe ali ndi pakati. Pali chiopsezo chachikulu cha zotsatira zoyipa za chinthu chomwe chikukula pakubadwa kwa mwana ndi moyo wake. Muyenera kupewa kugwiritsa ntchito mankhwalawa ngakhale mukamakonzekera mwana wosabadwa. Ponena za nthawi ya mkaka wa m'mawere, madokotala akuti Viktoza kwenikweni simalowa mkaka wa m'mawere. Pankhaniyi, ngakhale mukuyamwitsa, sikulimbikitsidwa kumwa nawo.
Popeza mankhwalawa amagwiritsidwa ntchito pochiza matenda ashuga komanso amathandizira pakukula kwa kulemera kwa odwala am'gulu lino, anthu ena athanzi amagwiritsa ntchito ngati njira yochepetsera thupi.
Madokotala amalimbikitsa kuti asamagwiritse ntchito zinthu ngati izi, chifukwa pamakhala chiopsezo chachikulu chotenga khansa ya chithokomiro pakumwa mankhwalawa mwa anthu athanzi.
Ndi zotulukapo zoipa ziti zomwe zingachitike?
Mukamagwiritsa ntchito mankhwalawa, mavuto amabwera.
Kulephera kutsatira malingaliro a dokotala yemwe akupezekapo, kunyalanyaza malangizo omwe afotokozedwa m'malangizo ogwiritsira ntchito mankhwalawa, kungayambitse mavuto.
Makamaka, kuwonetsa koipa kotere kumapezeka pa magawo oyamba a njira yochizira.
Zotsatira zoyipa zomwe zimachitika chifukwa ch kumwa mankhwalawa ndiwonetsero wa izi:
- Kuphwanya kagayidwe kachakudya njira. Zomwe zikuluzikulu ndizochita nseru, kusanza, kutsegula m'mimba kapena kudzimbidwa, kupweteka pamimba, kutaya kwathunthu chilakolako cha chakudya. Nthawi zina, madzi amawonongeka.
- Mitsempha yapakati imatha kupereka zizindikiritso zam'mutu kwambiri.
- Zotsatira zoyipa za ziwalo zam'mimba zambiri zimachitika, monga kutukuka kapena kufalikira kwa gastritis, gastroesophageal Reflux, belching, bloating ndi kuchuluka kwa mpweya. Osowa kwambiri, odwala amadandaula za chitukuko cha pancreatitis pachimake.
- Kusokonezeka kwa chitetezo cha mthupi kumatha kuwonetsa monga anaphylactic reaction.
- Mu mawonekedwe opatsirana njira ya chapamwamba kupuma thirakiti.
- Zotsatira zoyipa kuchokera jakisoni.
- Kutopa kwathupi komanso thanzi lathanziꓼ
- Mbali ya genitourinary system, zotsatira zoyipa zimadziwonetsa ngati kulephera kwa impso, kusokonezeka kwa matenda a impso
- Mavuto ndi khungu. Nthawi zambiri, izi zimawonekera ngati mawonekedwe totupa pakhungu, urticaria, ndi kuyabwa.
Mu mawonekedwe a hypoglycemia, zovuta zosagwirizana ndi odwala zimawonetseredwa pafupipafupi. Zotsatira zoterezi zimatha kuchitika ngati mulingo wosayang'aniridwa bwino, makamaka muziphatikiza ndi mankhwala ena ochepetsa shuga. Muzochita zamankhwala, hypoglycemia yoopsa idadziwika mu shuga ndikuphatikizira Viktoza ndi mankhwala ochokera ku gulu la zotumphukira za sulfonylurea.
Kuphatikiza apo, kumwa mankhwalawa nthawi zina kumatha kukhala limodzi ndi kusintha kwa thupi lawo siligwirizana, komwe kumawonekera mu mawonekedwe a urticaria, totupa, kupumira movutikira, komanso kuwonjezeka pafupipafupi kumenyedwa kwa mtima.
Ndi mankhwala osokoneza bongo ochulukirapo maulendo makumi anayi, adakanidwa m'njira ya mseru komanso kusanza kwambiri. Nthawi yomweyo, kuchuluka kwa shuga m'magazi sikunagwere kwambiri.
Ngati bongo, tikulimbikitsidwa kutsatira malangizo a dokotala ndikupita njira yodziwika bwino yochizira.
Kodi ndizotheka kusintha Viktoza ndikugulitsa ndi katundu wofanana?
Mpaka pano, pamsika wa pharmacological mulibe chithunzi chonse cha mankhwala a Viktoza.
Mtengo wa mankhwalawa, choyambirira, zimatengera kuchuluka kwa zolembera m'matumba.
Mutha kugula mankhwala mumasitolo amzinda kuchokera ku ruble 7 mpaka 11,2.
Mankhwala otsatirawa ndi ofanana mu zotsatira zawo zamankhwala, koma ndi mankhwala ena:
- Novonorm ndi mankhwala a piritsi omwe amachepetsa shuga m'thupi. Wopanga mankhwalawa ndi Germany. Chofunikira chachikulu pa chinthu ndi mankhwala. Nthawi zambiri amagwiritsidwa ntchito posagwiritsa ntchito mankhwala osokoneza bongo omwe amadalira shuga, monga chida chachikulu kapena kuphatikiza mankhwala ndi metformin kapena thiazolidinedione. Mtengo wa mankhwalawa, kutengera mlingo, umasiyana kuchokera ku ma 170 mpaka ma ruble 230.
- Baeta ndi mankhwala osokoneza bongo omwe amadziwika kuti ndi othandizira polimbana ndi zovuta za matenda a shuga. Amapezeka mu mawonekedwe a yankho la subcutaneous jakisoni. Chofunikira chachikulu ndi exenatide. Mtengo wamba wa mankhwalawa m'masitolo ndi ma ruble 4,000.
Kuphatikiza apo, analogi ya mankhwala Viktoza ndi Luxumia
Dokotala wokha ndi amene angaganize zofunikira pakuthandizanso mankhwalawa panthawi yochizira.
Kanemayo munkhaniyi amafotokoza za mankhwala omwe amachepetsa shuga ya magazi.
