Onglisa ndi mankhwala a odwala matenda ashuga, chophatikiza chomwe ndi saxagliptin. Saxagliptin ndi mankhwala wovomerezeka pochizira matenda amishuga a 2.
Pasanathe maola 24 mutakhazikitsa, amalepheretsa enzyme DPP-4. Kulepheretsa kwa enzyme mukamayanjana ndi glucose kumawonjezeka ndi 2P3 kuchuluka kwa glucagon-ngati peptide-1 (pano ndi GLP-1) ndi shuga wodalira shuga.
Zotsatira zake, zomwe zimakhala ndi insulin ndi C-peptide m'thupi zimakulanso. Insulin itatulutsidwa ndi maselo a beta a kapamba ndi glucagon kuchokera ku maselo a alpha, glycemia wofulumira ndi postprandial glycemia amachepetsa kwambiri.
Kugwiritsa ntchito bwino kwa saxagliptin mu Mlingo wosiyanasiyana komwe kwaphunziridwa mosamala bwino m'maphunziro asanu ndi amodzi olamulidwa ndi placebo, omwe adakhudza odwala 4148 omwe adapezeka ndi mtundu wachiwiri wa matenda a shuga.
M'maphunzirowa, kusintha kwamphamvu kwa glycated hemoglobin, kusala kwamadzi am'magazi komanso glucose wa postprandial adadziwika. Odwala omwe saxagliptin monopoly omwe sanatulutse zotsatira zomwe amayembekezeredwa adapangidwanso mankhwala monga metformin, glibenclamide ndi thiazolidinediones.
Umboni wochokera kwa odwala ndi madokotala: masabata 4 atatha chithandizo, saxagliptin yokha, kuchuluka kwa hemoglobin ya glycated kunachepa, ndipo kuchuluka kwa glucose kosala kudya kunatsika pambuyo pa masabata awiri.
Zizindikiro zomwezo zidalembedwa mu gulu la odwala omwe adalembedwa mankhwala ophatikiza ndi kuwonjezeredwa kwa metformin, glibenclamide ndi thiazolidinedione, ma analogu adagwiranso ntchito molingana.
M'njira zonsezi, kuwonjezeka kwa odwala sikunachitike.
Mukamagwiritsa ntchito ongliza
Mankhwala amathandizidwa ndi odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga m'mikhalidwe yotere:
- Ndi monotherapy ndi mankhwalawa limodzi ndi zolimbitsa thupi ndi zakudya mankhwala;
- Ndi mankhwala othandizira osakanikirana ndi metformin;
- Palibe mphamvu ya monotherapy ndi metformin, zotumphukira za sulfonylurea, thiazolidinediones ngati mankhwala ena.
Ngakhale kuti mankhwala osokoneza bongo akhala akupanga kafukufuku ndi mayeso angapo, kuwunika za izi ndizabwino kwambiri, chithandizo chokhacho chitha kuyamba kuyang'aniridwa ndi dokotala.
Contraindative pa ntchito yopanda tanthauzo
Popeza mankhwalawa amakhudza magwiridwe antchito a beta ndi ma alpha, amalimbikitsa kwambiri ntchito yawo, sangathe kugwiritsidwa ntchito nthawi zonse. Mankhwala okhazikika:
- Pa nthawi yoyembekezera, pobereka komanso mkaka wa m'mawere.
- Achinyamata osakwana zaka 18.
- Odwala omwe ali ndi mtundu woyamba wa matenda a shuga (machitidwe osaphunziridwa).
- Ndi mankhwala a insulin.
- Ndi matenda ashuga ketoacidosis.
- Odwala wobadwa nawo galactose tsankho.
- Ndi chidwi cha aliyense pazinthu zilizonse za mankhwala.
Palibe chifukwa chomwe malangizo a mankhwalawo anganyalanyazidwe. Ngati mukukayika za chitetezo chazogwiritsidwa ntchito, ma analog inhibitors kapena njira ina yothandizira ayenera kusankhidwa.
Mlingo Wovomerezeka ndi Kachitidwe
Onglisa amagwiritsidwa ntchito pakamwa, osatchula chakudya. Pafupifupi tsiku lililonse mankhwala ndi 5 mg.
Ngati mankhwala ophatikiza aphatikizidwa, mlingo wa saxagliptin sunasinthidwe, Mlingo wa metformin ndi zotumphukira za sulfonylurea umatsimikiziridwa mosiyana.
Kumayambiriro kwa kuphatikiza mankhwalawa pogwiritsa ntchito metformin, mlingo wa mankhwalawa ukhale motere:
- Onglisa - 5 mg patsiku;
- Metformin - 500 mg patsiku.
Ngati zochita zosakwanira zadziwika, mlingo wa metformin uyenera kusintha, umachulukitsidwa.
Ngati, pazifukwa zilizonse, nthawi yakumwa mankhwalawo idasemphana, wodwalayo ayenera kumwa mapilitsi mwamsanga. Sikoyenera kuwirikiza kawiri mlingo wa kawiri.
Kwa odwala omwe ali ndi matenda opatsika pang'ono aimpso, ndikofunikira kuti musinthe mwanjira ina. Ndi kusokonezeka kwa impso kwamitundu yozama komanso yozama ya owlis ayenera kumwedwa m'magawo ang'onoang'ono - 2,5 mg kamodzi patsiku.
Ngati hemodialysis ichitika, onglisa amatengedwa kumapeto kwa gawo. Zotsatira za saxagliptin pa odwala omwe akudwala peritoneal dialysis sizinafufuzidwebe. Chifukwa chake, musanayambe mankhwala ndi mankhwalawa, kuyenera kuchitika kwa impso kuyenera kuchitidwa.
Ndi vuto la chiwindi, kupezeka mwachindunji muyezo wake muyezo - 5 mg tsiku. Zochizira odwala okalamba, zachidziwitso zimagwiritsidwanso ntchito chimodzimodzi. Koma tikumbukire kuti chiopsezo chokhala ndi kulephera kwa aimpso m'gulu lino la odwala matenda ashuga ndiwambiri.
Palibe ndemanga kapena kafukufuku wapadera wazomwe zimachitika chifukwa cha mankhwalawa kwa odwala ochepera zaka 18. Chifukwa chake, kwa achinyamata omwe ali ndi matenda a shuga a 2, ma fanizo okhala ndi chinthu china chogwira ntchito amasankhidwa.
Kuwalitsa mulingo woyenera wofunikanso ndikofunikira ngati mankhwalawo adapangidwira pamodzi ndi mankhwala amphamvu. Izi ndi:
- ketoconazole,
- madalin,
- atazanavir
- indinavir
- igraconazole
- nelfinavir
- ritonavir
- saquinavir ndi telithromycin.
Chifukwa chake, mlingo woyenera tsiku ndi tsiku ndi 2,5 mg.
Zambiri za chithandizo cha amayi apakati komanso zoyipa
Sizinaphunziridwe momwe mankhwalawa amakhudzira nthawi ya kubereka, komanso ngati amatha kulowa mkaka wa m'mawere, chifukwa chake, mankhwalawa sanalembedwe panthawi yakubala ndi kudyetsa mwana. Ndikulimbikitsidwa kugwiritsa ntchito ma analogu ena kapena kusiya kuyamwitsa.
Nthawi zambiri, kutsatira kuchuluka ndi malingaliro a mankhwala ophatikiza, mankhwalawa amaloledwa bwino, kawirikawiri, monga momwe ndemanga zimatsimikizira, zotsatirazi zingaoneke:
- Kubweza
- Gastroenteritis;
- Mutu;
- Mapangidwe matenda opatsirana a chapamwamba kupuma thirakiti;
- Matenda opatsirana a genitourinary system.
Ngati pali chizindikiro chimodzi kapena zingapo, muyenera kuyimitsa mankhwalawo kapena kusintha mankhwalawo.
Malinga ndi ndemanga, ngakhale patakhala kuti zosafunikira zimagwiritsidwa ntchito kwa nthawi yayitali mu milingo yopitilira 80, palibe chizindikiro chakupha. Kuchotsa mankhwalawa m'thupi ngati muledzera, njira ya geomdialysis imagwiritsidwa ntchito.
Zina zomwe muyenera kudziwa
Onglis sanalembedwe ndi insulin kapena mankhwala patatu ndi metformin ndi thiazolididones, popeza maphunziro a kuyanjana kwawo sanachitike. Ngati wodwala akudwala pang'ono komanso wamphamvu kulephera kwa impso, mlingo wa tsiku ndi tsiku uyenera kuchepetsedwa. Anthu odwala matenda ashuga omwe ali ndi vuto lofooka laimpso amafunikira kuwunika momwe impso ikuthandizira.
Kukhazikitsidwa kuti zopezeka mu sulfonylureas zimatha kupangitsa hypoglycemia. Kuti mupewe chiopsezo cha hypoglycemia, mulingo wa sulfonylurea wophatikiza ndi chithandizo chodziwikiratu uyenera kusintha. Ndiye kuti, kuchepetsedwa.
Ngati wodwala ali ndi mbiri ya hypersensitivity kwa zoletsa zilizonse zofanana za DPP-4, saxagliptin sichosankhidwa. Ponena za chitetezo ndi kugwiritsa ntchito bwino mankhwalawa kwa odwala okalamba (opitilira zaka 6), palibe machenjezo pankhaniyi. Onglisa amalekeredwa ndipo amachita chimodzimodzi ndi odwala achinyamata.
Popeza mankhwalawa ali ndi lactose, sioyenera kwa iwo omwe ali ndi vuto lodana ndi izi, kuperewera kwa lactose, glucose-galactose malabsorption.
Mphamvu ya mankhwalawa pa kuyendetsa magalimoto ndi zida zina zofunikira kwambiri kuti adziyang'anitsitse sizinaphunzire konse.
Palibe zotsutsana mwachindunji poyendetsa galimoto, koma ziyenera kukumbukiridwa kuti pakati pazotsatira zoyipa ndi kupweteka kwa mutu kumadziwika.
Kuchita ndi mankhwala ena
Malinga ndi mayesero azachipatala, chiopsezo cha kuyanjana ndi mankhwala osagwirizana ndi mankhwala ena, ngati atengedwa nthawi imodzi, ndizochepa kwambiri.
Asayansi sanakhazikitse momwe kusuta, kuledzera, kugwiritsa ntchito mankhwala ofooketsa, kapena chakudya chamagulu kumakhudza zotsatira za mankhwalawa, chifukwa cha kusowa kwa kafukufuku m'derali.
