Anthu omwe ali ndi matenda osokoneza bongo a mtundu 2 sangathe kukhalabe ndi glucose pamlingo wabwinobwino chifukwa chogwira ntchito zolimbitsa thupi imodzi komanso chakudya chapadera chomwe sichimaphatikizanso chakudya chamafuta ndi mafuta.
Vutoli limachitika nthawi yayitali ndimatenda ambiri, chifukwa chaka chilichonse mphamvu za kapamba zimawonongeka. Kenako mapiritsi a Galvus amabwera kudzakuthandizani, omwe amachepetsa ndikuchepetsa shuga mkati mwa zikhalidwe zabwino.
Anthu ambiri odwala matenda ashuga amakonda kudziwa momwe mankhwala okhala ndi vildagliptin alili. Chifukwa chake, nkhaniyi ikuwunikira momwe zinthu zimagwirira ntchito komanso zomwe zimagwiritsidwa ntchito, kuti aliyense athe kudzitsimikizira yekha phindu la mankhwala a hypoglycemic.
Zotsatira za pharmacological
Vildagliptin (Mtundu wacilatini - Vildagliptinum) ndi gulu la zinthu zomwe zimapangitsa kuti zisumbu za Langerhans zitheke komanso zoletsa zochitika za dipeptidyl peptidase-4. Zotsatira za puloteni iyi ndizowononga mtundu wa 1 glucagon-peptide (GLP-1) ndi insulinotropic polypeptide (HIP) ya glucose.
Zotsatira zake, machitidwe a dipeptidyl peptidase-4 amathandizidwa ndi zinthuzo, ndipo kupanga kwa GLP-1 ndi HIP kumalimbikitsidwa. Mipira yawo ikachuluka, vildagliptin imapangitsa chidwi cha maselo a beta kukhala ndi glucose, yomwe imawonjezera kupanga kwa insulin. Kukula kwa magwiridwe antchito a maselo a beta kumadalira mwachindunji kuwonongeka kwawo. Chifukwa chake, mwa anthu omwe ali ndi shuga wathanzi akamagwiritsa ntchito mankhwala okhala ndi vildagliptin, sizikhudza kupangika kwa timadzi timene timachepetsa shuga ndipo, motero, shuga.
Kuphatikiza apo, mankhwalawa akachulukitsa zomwe zili mu GLP-1, nthawi yomweyo, mphamvu ya glucose imawonjezeka m'maselo a alpha. Kuchita koteroko kumakhudza kuwonjezeka kwa malamulo omwe amadalira glucose opanga maselo alpha maselo, otchedwa glucagon. Kutsitsa kuchuluka kwake pogwiritsira ntchito mbale kumathandizira kuthetsa chitetezo chokwanira cha cell insulin.
Pomwe kuchuluka kwa insulin ndi glucagon kumawonjezeka, komwe kumatsimikiziridwa ndi kuchuluka kwa HIP ndi GLP-1, mu boma la hyperglycemic, shuga m'magazi amayamba kupanga pang'ono, nthawi yonse ya chakudya komanso pambuyo pake, zomwe zimapangitsa kuchepa kwa glucose m'magazi a shuga.
Tiyenera kudziwa kuti, pogwiritsa ntchito Vildagliptin, kuchuluka kwa lipids kumachepa mukatha kudya. Kuwonjezeka kwa zomwe zili mu GLP-1 nthawi zina kumayambitsa kuchepa kwam'mimba, ngakhale kuti izi sizinapezeke pakubaya.
Kafukufuku waposachedwa wokhudzana ndi odwala pafupifupi 6,000 pamasabata 52 adatsimikizira kuti kugwiritsa ntchito vildagliptin kumatsitsa shuga pamimba yopanda kanthu komanso glycated hemoglobin (HbA1c) pamene mankhwalawa amagwiritsidwa ntchito:
- monga maziko a mankhwala;
- kuphatikiza ndi metformin;
- kuphatikiza ndi sulfonylureas;
- kuphatikiza ndi thiazolidinedione;
Mlingo wa glucose umatsikanso ndi kuphatikiza kwa vildagliptin ndi insulin.
Malangizo ogwiritsira ntchito mapiritsi
Pa msika wama pharmacological, mutha kupeza mankhwala awiri okhala ndi vildagliptin.
Kusiyanako kuli pazomwe zikugwira ntchito: poyambirira, ndi vildagliptin kokha, ndipo chachiwiri - vildagliptin, metformin.
Opanga mankhwala oterewa ndi kampani yaku Swiss ya Novartis.
Mankhwala akupezeka mu mitundu yotsatira:
- Vildagliptin yopanda zigawo zina zowonjezera (pamapiritsi 28 zidutswa phukusi la 50 mg);
- Vildagliptin osakanikirana ndi Metformin (mapiritsi 30 mu phukusi la 50/500, 50/850, 50/1000 mg).
Choyamba, wodwala wodwala yemwe samadalira insulini amadalira othandizirana kuti alembe mankhwala mosalephera. Popanda izi, mutha kupeza yankho. Kenako wodwalayo ayenera kuwerengako mosamala ndikukhazikitsa, ngati muli ndi mafunso, afunseni adokotala. Malangizo ogwiritsira ntchito mankhwalawa ali ndi mndandanda wa Mlingo woyenera womwe ungasinthidwe ndi dokotala.
Vildagliptin 50 mg, monga chida chachikulu, kuphatikiza ndi thiazolidinedione, Metformin kapena insulin, amatengedwa mu Mlingo watsiku ndi tsiku wa 50 kapena 100 mg. Anthu odwala matenda ashuga, omwe matendawo amakula kwambiri ndi mankhwala a insulin, amatenga 100 mg patsiku.
Kuphatikiza kwapawiri kwa mankhwalawa (vildagliptin ndi zotumphukira za sulfonylurea) kumawonetsa tsiku lililonse 50 mg m'mawa.
Kuphatikiza katatu kwa mankhwalawa, i.e. Vildagliptin, Metformin ndi zotumphukira za sulfonylurea, zikusonyeza kuti tsiku lililonse 100 mg.
Mlingo wa tsiku ndi tsiku wa 50 mg umagwiritsidwa ntchito nthawi imodzi m'mawa, ndi 100 mg m'magawo awiri m'mawa ndi madzulo. Kusintha kwa magazi mwa anthu omwe ali ndi vuto locheperako kapena aimpso kwambiri (makamaka, ndi kuperewera kwa vuto) angafunike.
Mankhwalawa amasungidwa m'malo osagwiritsidwa ntchito ndi ana aang'ono, kutentha kwambiri osapitirira 30C. Nthawi yosungirako ndi zaka 3, nthawi yomwe ikuwonetsedwa ikatha, mankhwalawa sangathe kugwiritsidwa ntchito.
Contraindication ndi zomwe zingavulaze
Vildagliptin ilibe zotsutsana zambiri. Amalumikizidwa ndi kusalolera kwa wodwala pantchito ndi zinthu zina, komanso chibadwa cha galactose, kuperewera kwa lactase ndi malabsorption a glucose-galactose.
Tiyenera kukumbukira kuti chifukwa cha kuchepa kwa kafukufuku, chitetezo chogwiritsa ntchito mankhwalawa kwa ana ndi achinyamata (osakwana zaka 18) sichinaphunzire konse.
Palibe zowerengera pazakugwiritsa ntchito vildagliptin pa nthawi yoyembekezera komanso yoyamwitsa, kotero kugwiritsa ntchito mankhwalawa panthawi imeneyi kumaletsedwa.
Kutengera ngati Vildagliptin amagwiritsidwa ntchito ngati monotherapy kapena mwanjira zina, zotsatira zoyipa zingapo zingachitike:
- monotherapy (Vildagliptin) - mkhalidwe wa hypoglycemia, mutu ndi chizungulire, kudzimbidwa, zotumphukira edema;
- Vildagliptin, Metformin - chikhalidwe cha hypoglycemia, kugwedeza, chizungulire komanso kupweteka mutu;
- Vildagliptin, zotumphukira za sulfonylurea - mkhalidwe wa hypoglycemia, kunjenjemera, chizungulire komanso kupweteka mutu, asthenia (psychopathological disorder);
- Vildagliptin, zotumphukira za thiazolidinedione - mkhalidwe wa hypoglycemia, kuwonjezeka pang'ono kwa kulemera, zotumphukira edema;
- Vildagliptin, insulin (kuphatikiza kapena yopanda metformin) - mkhalidwe wa hypoglycemia, mutu, gastroesophageal Reflux (kuponya zomwe zili m'mimba m'mphepete), kuzizira, nseru, kupangika kwamagesi kwambiri, kutsekula m'mimba.
Pakafukufuku wam'mbuyo atagulitsa, odwala matenda ashuga ambiri omwe amatenga Vildagliptin adawona zosokoneza monga hepatitis, urticaria, kutulutsa khungu, mapangidwe a matuza komanso kukula kwa kapamba.
Ngakhale, mankhwalawa ali ndi mndandanda wazotsatira zoyipa, kupezeka kwake kumakhala kochepa. Mwambiri, zimachitika kwakanthawi ndipo ngakhale mawonetsedwe awo, kuthetsedwa kwa chithandizo sikufunika.
Mankhwala osokoneza bongo ndi malingaliro oyenera kugwiritsa ntchito
Mwambiri, Vildagliptin imalekeredwa bwino ndi odwala pamtunda wa tsiku ndi tsiku wa 200 mg, koma osatinso. Mukamagwiritsa ntchito mlingo waukulu kuposa momwe amafunikira, pali kuthekera kwakukulu kwa zizindikiro za mankhwala osokoneza bongo.
Dziwani kuti mukasiya kumwa mankhwalawo, zizindikiro zonse zimachoka.
Zizindikiro za bongo zimadalira pamlingo wake, mwachitsanzo:
- Pamene 400 mg yagwiritsidwa ntchito, kupweteka kwa minofu, kutupa, kugwedezeka ndi kuperewera kwa malekezero (mapapu ndi ofufuza), kuchuluka kwakanthawi kochepa kwa lipase kumachitika. Komanso, matenthedwe amatha kuwuka ndi matenda ashuga.
- Mukamagwiritsa ntchito 600 mg, kutupa kwa manja ndi miyendo kumawonekera, komanso kutsekeka kwake ndikung'ung'udza, kuchuluka kwa ALT, CPK, myoglobin, komanso mapuloteni a C-reactive.
Kumayambiriro kwa mankhwalawa, muyenera kuphunzira magawo a chiwindi. Zotsatira zikawonetsa ntchito yowonjezera ya transaminase, kuwunikiranso kuyenera kubwerezedwanso ndikuyenda pafupipafupi mpaka zizindikiro zizikhazikika. Ngati zotsatira za mayeso zikuwonetsa ntchito za ALT kapena AST, zomwe ndizokwera katatu kuposa VGN, mankhwalawo amayenera kuthetsedwa.
Ngati wodwalayo aphwanya chiwindi (mwachitsanzo, jaundice), kugwiritsa ntchito mankhwalawo nthawi yomweyo kumatha. Ngakhale chiwindi sichimatenga matenda, chithandizo chimaletsedwa.
Ngati chithandizo cha insulin chikufunika, vildagliptin imagwiritsidwa ntchito pokhapokha ndi mahomoni. Komanso, kugwiritsidwa ntchito kwake sikulimbikitsidwa pochiza matenda amisomali amadwala matenda a shuga (mtundu 1) kapena matenda a kagayidwe kazakudya - matenda ashuga ketoacidosis.
Kukhoza kwa vildagliptin kuchititsa chidwi cha anthu sikumveka bwino. Komabe, ngati chizungulire chachitika, odwala omwe amayendetsa magalimoto kapena amagwira ntchito zina ndi zina amayenera kusiya ntchito yowopsa imeneyo kuti akwaniritse nthawi yayitali.
Mtengo, ndemanga ndi fanizo
Popeza mankhwalawa Vildagliptin ndiwomwe (ogulitsa Switzerland), motero mtengo wake sudzakhala wotsika kwambiri. Komabe, wodwala aliyense amene ali ndi ndalama zambiri amatha kugula mankhwalawo. Chidacho chitha kugulidwa ku malo azamankhwala kapena kuyitanidwa pa intaneti.
Mtengo wa mankhwalawa (mapiritsi 28 a mapiritsi a 50 mg) amasiyana kuchokera ku 750 mpaka 880 rubles aku Russia.
Ponena za malingaliro a madotolo ndi odwala okhudzana ndi kugwiritsa ntchito mankhwalawa, kuwunika kuli bwino.
Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri omwe amamwa mapiritsi amawunikira zotsatirazi zabwino za mankhwalawa:
- kuchepa msanga kwa shuga ndikuyisunga munthawi yochepa;
- kugwiritsa ntchito njira mosavuta;
- mawonekedwe osowa kwambiri osokoneza bongo.
Kutengera izi, mankhwalawa atha kudziwika ngati mankhwala othandizira a hypoglycemic polimbana ndi matenda a shuga a 2. Koma nthawi zina pokhudzana ndi contraindication kapena kuvulaza komwe kungachitike, muyenera kukana kugwiritsa ntchito mankhwalawa. Muzochitika zotere, katswiri wothandizirayu amapereka ma analogues - othandizira omwe ali ndi chithandizo chofanana ndi Vildagliptin. Izi zikuphatikiza:
- Onglisa. Zomwe zimagwiritsidwa ntchito ndi saxagliptin. Mtengo umasiyanasiyana poyerekeza ndi ma ruble 1900.
- Trazenta. Chosakaniza chophatikizacho ndi linagliptin. Mtengo wapakati ndi ma ruble 1750.
- Januvius. Zomwe zimagwiritsidwa ntchito ndi sitagliptin. Mtengo wapakati ndi ma ruble 1670.
Monga mukuwonera, ma analogi ali ndi zigawo zosiyanasiyana pakuphatikizika kwawo. Pankhaniyi, adokotala ayenera kusankha mankhwalawa kuti asayambitse wodwalayo. Tiyenera kudziwa kuti ma analogues amasankhidwa kutengera mtengo wamtengo, amakhalanso ndi gawo lofunikira.
Mankhwala a Galvus vildagliptin (Latin - Vildagliptinum), amawerengedwa ngati mankhwala othandiza a hypoglycemic, omwe amatengedwa ngati maziko komanso osakanikirana ndi mankhwala ena. Mwachitsanzo, kuphatikiza kwa vildagliptin, metformin yokhala ndi zotumphukira za sulfonylurea. Kugwiritsa ntchito mankhwalawa ndikuloletsedwa, muyenera kutsatira malangizo a dokotala nthawi zonse. Inde, ngati mankhwalawo sangathe kumwa pazifukwa zina, dokotalayo amamufotokozera. Kanemayo munkhaniyi apitiliza mutu wa mankhwalawa kwa odwala matenda ashuga.
