Onglisa - mankhwala a shuga am'badwo watsopano

Onglisa ndi m'modzi mwa oimira gulu latsopano la othandizira a hypoglycemic, DPP-4 zoletsa. Mankhwala ali ndimapangidwe osiyana siyana ochokera ku mapiritsi ena a antidiabetes. Pakuchita bwino, Ongliza amafananizidwa ndi njira zachikhalidwe; pankhani yachitetezo, imagwiritsa ntchito kwambiri. Kuphatikiza apo, mankhwalawa ali ndi zotsatira zabwino pazinthu zokhudzana, amachepetsa kupita patsogolo kwa matenda ashuga komanso kukula kwa zovuta.

Asayansi akukhulupirira kuti kupangidwa kwa zoletsa izi ndi gawo lofunikira kwambiri pakuchiza matenda a shuga. Amaganiziridwa kuti kupeza kwotsatira kudzakhala mankhwala osokoneza bongo omwe atha kubwezeretsa ntchito kwa pancreatic kwa nthawi yayitali.

Kodi mankhwala a Onglisa adaupangira chiyani?

Matenda a 2 a mtundu wa 2 amadziwika ndi kuchepa kwamphamvu kwa maselo a pancreatic kupita ku glucose, kuchepetsedwa gawo loyamba la insulin synthesis (poyankha zakudya zamatumbo). Ndi kuchuluka kwa matendawa, gawo lachiwiri la kupanga mahomoni limatayika pang'onopang'ono. Amakhulupirira kuti chomwe chimayambitsa kusagwira bwino kwa maselo a beta omwe amapanga insulin ndi kusowa kwa ma insretin. Awa ndi ma peptides omwe amathandizira kubisalira kwa mahomoni, amapangidwa mogwirizana ndi kuchuluka kwa shuga m'magazi.

Onglisa akuchedwa kuchitapo kanthu kwa enzyme ya DPP-4, yomwe ndi yofunika kuti awonongeke. Zotsatira zake, amakhalabe m'mwazi motalikirapo, zomwe zikutanthauza kuti insulini imapangidwa m'njira yayikulu kuposa masiku onse. Izi zimathandiza kukonza glycemia komanso pamimba yopanda kanthu, ndipo mukatha kudya, bweretsani ziphuphu zakumaso pafupi ndi zofunikira zathupi. Pambuyo pa kusankha kwa Akulisa, glycated hemoglobin mwa odwala imachepetsedwa ndi 1.7%.

Kuchita kwa Onglises kutengera kuchuluka kwa ntchito ya mahomoni ake, mankhwalawa amawonjezera kuchuluka kwawo m'magazi osachepera 2 nthawi. Pamene glycemia ikuyandikira yachilendo, ma insretin amasiya kutengera kapangidwe ka insulin. Pankhani imeneyi, palibe chowopsa cha hypoglycemia mu odwala matenda ashuga omwe amamwa mankhwalawa. Komanso, mwayi wosakayikitsa wa Onglisa ndikuchepa kwa kuthamanga kwake komanso kuthekera kotenga mapiritsi ena ochepetsa shuga.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

Kuphatikiza pa chochita chachikulu, Onglisa amakhalanso ndi zotsatira zina zabwino mthupi:

1. Mankhwalawa amachepetsa kuchuluka kwa shuga kuchokera m'matumbo kulowa m'magazi, potero amathandizira kuchepa kwa matenda a shuga a insulin komanso shuga atatha kudya.
2. Amatenga nawo mbali pamakhalidwe azakudya. Malinga ndi odwala, Onglisa amathandizira kumverera kwodzaza, zomwe ndizofunikira kwambiri kwa odwala matenda ashuga onenepa kwambiri.
3. Mosiyana ndi kukonzekera kwa sulfonylurea, komwe kumakulanso kaphatikizidwe ka insulin, Onglisa siivulaza maselo a beta. Kafukufuku awulula kuti sikuti amangowononga ma cell a pancreatic, koma, mmalo mwake, amateteza komanso kuwonjezera kuchuluka kwawo.

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwalawa amapangidwa ku United States ndi kampani ya Anglo-Sweden ya AstraZeneca. Mapiritsi okonzedwa okonzeka akhoza kuikidwa mu Italy kapena ku UK. Mu phukusi la matuza 3 opaka mapiritsi 10 lililonse ndi malangizo ogwiritsa ntchito.

Zomwe zimagwiritsidwa ntchito ndi mankhwala ndi saxagliptin. Ichi ndi chatsopano kwambiri mwa omwe akugwiritsa ntchito DPP-4 zoletsa; adalowa msika mu 2009. Monga zigawo zothandizira, lactose, cellulose, magnesium stearate, croscarmellose sodium, utoto umagwiritsidwa ntchito.

Onglisa ali ndi Mlingo 2 - 2,5; 5 mg Mapiritsi 2.5 mg wachikasu, mankhwala oyamba amatha kusiyanitsidwa ndi zolembedwa za 2.5 ndi 4214 mbali iliyonse ya piritsi. Onglisa 5 mg ali ndi utoto pinki, wokhala ndi nambala 5 ndi 4215.

Mankhwalawa ayenera kupezeka kuti akugulitsidwa ndi mankhwala, koma mankhwalawa sawonedwa m'mafamu onse azachipatala. Mtengo wa Onglizu ndiwokwera kwambiri - pafupifupi ma ruble 1900. pa paketi iliyonse. Mu 2015, saxagliptin idaphatikizidwa pamndandanda wa mankhwala osokoneza bongo a Vital and Essential, kotero odwala matenda ashuga omwe amatha kulembetsa amatha kuyesa mapiritsi awa kwaulere. Ongliza alibebe zamagetsi, chifukwa chake ayenera kupereka mankhwala oyambirirawo.

Momwe angatenge

Onglisa adalembera matenda ashuga amtundu 2. Kuchiza mosakayikira kuyenera kuphatikizapo zakudya komanso masewera olimbitsa thupi. Musaiwale kuti mankhwalawa amachita modekha. Ndi kumwa kosaletseka kwa zakudya zamagalimoto komanso moyo wongokhala, sangathe kubwezera zomwe zimachitika chifukwa cha matenda ashuga.

The bioavailability wa saxagliptin ndi 75%, pazipita kuchuluka kwa zinthu m'magazi zimawonedwa pambuyo pa mphindi 150. Mphamvu ya mankhwalawa imatha pafupifupi maola 24, chifukwa chake sikofunikira kumwa chakudya. Mapiritsi ali mu chipolopolo cha filimu, sangathe kuthyoledwa ndi kuphwanyika.

Mlingo watsiku ndi tsiku womwe ndi 5 mg. Kwa odwala okalamba omwe ali ndi vuto lowonda laimpso ndi kwa chiwindi, kusintha kwa mankhwala sikofunikira.

Mlingo wocheperako (2.5 mg) sakonda kutumikiridwa:

• ndi kulephera kwa aimpso ndi GFR <50. Ngati matenda a impso akuwakayikira, tikulimbikitsidwa kuti ayesedwe ntchito yawo;
• kwakanthawi, ngati kuli kotheka, kudya maantibayotiki ena, ma antiviral, antifungal othandizira, mndandanda wawo wonse umasonyezedwa mu malangizo.

Malingaliro a Katswiri

Arkady Alexandrovich

Endocrinologist wodziwa zambiri

Funsani katswiri funso

Ngati wodwalayo wasowa kumwa mapiritsi, mutha kumwa masana. Kubwereza mlingo tsiku lotsatira ndi koletsedwa ndi malangizo. Mankhwala osokoneza bongo salimbikitsa chiwongolero cha matenda a shuga, koma samakhala pachiwopsezo chachikulu. Palibe poizoni yemwe adapezeka ngakhale atagwiritsidwa ntchito kamodzi pa 400 mg ya saxagliptin.

Contraindication ndi kuvulaza

Ongliz osasankhidwa:

1. Pa mimba, mkaka wa m`mawere. Mphamvu ya mankhwalawa pa chitukuko cha fetal, kuthekera kwa kulowa mkaka sikunaphunzirepo.
2. Ngati wodwalayo ali ndi zaka 18. Palibe deta yachitetezo chifukwa chosowa kafukufuku wokhudza ana.
3. Ngati hypersensitivity zimachitikira saxagliptin kale, mankhwala ena gulu limodzi, othandizira zigawo piritsi. Malinga ndi wopanga, chiopsezo chotere ndi 1.5%. Onsewa sanafune kuti wodwalayo azikhala nawo kuchipatala ndipo sizinali zoopsa pamoyo.
4. Ndi tsankho lactose.
5. Odwala omwe atseka kwathunthu kaphatikizidwe ka insulin yawo (mtundu 1 shuga, opaleshoni ya pancreatic).

Pakanthawi, mankhwalawa amasinthidwa ndi insulin mankhwala a ketoacidosis yayikulu, opaleshoni yayikulu ndikuvulala.

Onglisa ali ndi chitetezo chambiri. Ichi ndi chimodzi mwazamankhwala ochepetsa mphamvu ya shuga omwe alibe mavuto. Malinga ndi zotsatira za kafukufuku wazovuta kwa odwala omwe ali ndi saxagliptin, panali ambiri omwe anali mgululi omwe akuchitika. Komabe, malangizo ogwiritsira ntchito adawonetsa zovuta zonse zomwe zimakumana ndi odwala: kupuma komanso kwamikodzo matenda, chizungulire, kutsekula m'mimba, kusanza, kupweteka kwam'mimba, totupa, kuyabwa, kutopa.

Gwiritsani ntchito ndi mankhwala ena

Pofuna kupewa zovuta zambiri za anthu odwala matenda ashuga mamiliyoni ambiri, mankhwala atsopano ndi mitundu yochiritsira imayambitsidwa nthawi zonse. Chithandizo choyambira pano chimawonedwa ngati kusintha kwa moyo wa metformin +. Ngati izi sizokwanira, yambani kuphatikiza mankhwalawa: onjezerani imodzi mwa mankhwala ovomerezeka ku chithandizo chomwe chilipo.

Tsoka ilo, si onse amene ali otetezeka ndipo ogwira ntchito mokwanira:

Onglisa pankhani yothandizika ndiofanana ndi mankhwala omwe ali pamwambapa, ndipo pankhani yachitetezo ndi kuchepetsedwa kwa contraindication, imawonjezera kwambiri, chifukwa chake akuganiza kuti iwonjezedwa kwa odwala.

Russian Endocrinologists Association ivomereza kugwiritsa ntchito ma DPP-4 zoletsa kuphatikiza ndi metformin ngati mzere woyamba wa chithandizo cha matenda ashuga. Mankhwalawa onse samathandizira kuti hypoglycemia ichitike, imayambitsa zomwe zimapangitsa kuti shuga apezeke mosiyanasiyana: zimakhudza kukana kwa insulini komanso kusokonekera kwa khungu la beta.

Kuti achepetse dongosolo la chithandizo, wopanga yemweyo adapanga Combogliz Prolong. Mapiritsiwo ali ndi 500 kapena 1000 mg ya metformin yowonjezera-kutulutsa ndi 2.5 kapena 5 mg ya saxagliptin. Mtengo wa phukusi la pamwezi ndi pafupifupi ma ruble 3300. Analogue yathunthu ya mankhwalawa ndi kuphatikiza kwa Ongliza ndi Glucofage Long, zimatengera rubles chikwi zotsika mtengo.

Ngati onse mankhwalawa pazomwe mulingo woyenera sapereka pakufuna kwa shuga, amaloledwa kuwonjezera sulfonylureas, glitazones, insulin ku regimen yothandizira.

Kodi ndizotheka kusintha china

Onglisa ndiye mankhwala a saxagliptin okha mpaka pano. Ndili m'mawa kwambiri kunena za kuwoneka ngati mitengo yotsika mtengo, chifukwa chitetezo cha patent chitha kupezeka ndimankhwala atsopano, omwe amaletsa kutsitsa choyambirira. Chifukwa chake, wopanga amapatsidwa mwayi wokonzanso kafukufuku wokwera mtengo, kuti alimbikitse kupitiliza kwina kwa mankhwala opangira mankhwala. Yembekezerani kuchepetsa mtengo wa Ongliza sikuyenera.

M'masitolo ogulitsa aku Russia, kuphatikiza pa Onglisa, mutha kugula mapiritsi ku gulu lomwelo la Galvus ndi Januvius. Mankhwalawa ali ndi vuto lofanana ndi matenda a shuga, kufananiza pankhani yotetezeka komanso kuchita kwake sikunawonetse kusiyana kwakukulu pakati pawo. Malinga ndi ndemanga za anthu odwala matenda ashuga, mutha kuwapeza kwaulere osati kumadera onse, ngakhale kuti onse pachaka amaphatikizidwa pamndandanda wazamankhwala ofunika.

Kugula pawokha mankhwalawa kumawononga ndalama zambiri:

Mutha kuyitanitsa mapiritsi otsika mtengo pamafakitoreti apakompyuta. Mwa chachikulu kwambiri mwaiwo mungathe kumasuka ndi mankhwalawo kuchokera kuzipatala zomwe zili pafupi ndi nyumba.

Mu 2017, kumasulidwa kwa mankhwala ophatikiza ndi saxagliptin ndi dapagliflozin otchedwa Qtern adalengezedwa. Zimaphatikiza zabwino za imodzi mwazamankhwala apamwamba kwambiri a shuga - Forsigi ndi Onglisa. Ku Russia, mapiritsi atsopano sanalembedwebe.

Ndemanga