Liraglutide: malangizo ogwiritsira ntchito, mtengo, analogi, ndemanga

Liraglutide ndi amodzi mwa mankhwala atsopano omwe amachepetsa shuga ya magazi m'matumbo omwe ali ndi matenda ashuga. Mankhwalawa ali ndi mphamvu zambiri: amathandizira kupanga insulin, amalepheretsa kuphatikizika kwa glucagon, amachepetsa chilimbikitso, ndipo amachepetsa kuyamwa kwa shuga m'mazakudya. Zaka zingapo zapitazo, Liraglutide idavomerezedwa ngati njira yochepetsera kulemera kwa odwala omwe alibe shuga, koma kunenepa kwambiri. Ndemanga za iwo omwe akuchepetsa thupi akuwonetsa kuti mankhwalawa atha kukwaniritsa zotsatira zabwino kwa anthu omwe ataya kale chiyembekezo cha kulemera kwabwino. Polankhula za Liraglutida, munthu sangathe kulephera kutchula zolakwika zake: mtengo wokwera, kulephera kumwa mapiritsi mwanjira yokhazikika, chidziwitso chosakwanira pakugwiritsa ntchito.

Mawonekedwe ndi kapangidwe ka mankhwala

M'matumbo athu, timadzi tating'onoting'ono timapangidwira, momwe ma glucagon-peptide GLP-1 amathandizira pakuwonetsetsa kuti shuga ali ndi magazi. Liraglutide ndi analogue yopanga yopanga ya GLP-1. Kuphatikizika ndi kutsatana kwa ma amino acid mu molekyulu ya Lyraglutide akubwereza 97% ya peptide yachilengedwe.

Chifukwa cha kufanana uku, pakulowa m'magazi, chinthucho chimayamba kugwira ntchito ngati maholide achilengedwe: poyankha kuchuluka kwa shuga, imalepheretsa kutulutsa shuga ndikuyambitsa kuphatikizika kwa insulin. Ngati shuga ndiwabwinobwino, zochita za liraglutide zimayimitsidwa, motero, hypoglycemia siziwopseza odwala matenda ashuga. Zowonjezera za mankhwalawa zimalepheretsa kupanga kwa hydrochloric acid, kufooketsa mphamvu yam'mimba, kuponderezana ndi njala. Mphamvu imeneyi ya liraglutide pamimba ndi mphamvu yamanjenje imalola kuti igwiritsidwe ntchito pochotsa kunenepa kwambiri.

Natural GLP-1 imasweka mwachangu. Pakupita mphindi ziwiri zokha kuti amasulidwe, theka la peptide limatsalira m'magazi. Artificial GLP-1 ili m'thupi motalika, osachepera tsiku.

Liraglutide silingatengedwe pakamwa ngati mawonekedwe a mapiritsi, popeza m'matumbo amataya ntchito. Chifukwa chake, mankhwalawa amapezeka mu mawonekedwe a yankho ndi yogwira mtima ya 6 mg / ml. Kuti mugwiritse ntchito mosavuta, ma cartridge a solution amayikidwa m'matumba a syringe. Ndi chithandizo chawo, mutha kusankha mlingo woyenera ndikupanga jakisoni m'malo osayenera.

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%

Zizindikiro

Liraglutid idapangidwa ndi kampani yaku Danish NovoNordisk. Pansi pa malonda a Viktoza, agulitsidwa ku Europe ndi United States kuyambira 2009, ku Russia kuyambira 2010. Mu 2015, Liraglutide idavomerezeka ngati mankhwala ochizira kunenepa kwambiri. Mlingo woyenera wochepetsa thupi ndiwosiyana, motero chida chinayamba kumasulidwa ndi wopanga dzina lina - Saxenda. Viktoza ndi Saksenda ndi mitundu yosinthasintha; Zomwe zimapangidwira zimafanananso: sodium hydrogen phosphate, propylene glycol, phenol.

Victoza

Mu phukusi la mankhwalawa mumakhala zolembera ziwiri za syringe, iliyonse ndi 18 mg ya liraglutide. Odwala odwala matenda ashuga amalangizidwa kuti azigwiritsa ntchito kuposa 1.8 mg patsiku. Mlingo wamba wolipirira matenda a shuga kwa odwala ambiri ndi 1.2 mg. Ngati mumwa mankhwalawa, paketi ya Victoza ndi yokwanira mwezi umodzi. Mtengo wa ma CD ndi ma ruble 9500.

Saxenda

Kuti muchepetse kunenepa, mulingo wambiri wa liraglutide ndi wofunikira kuposa shuga. Kwambiri, maphunzirowa amalimbikitsa kumwa 3 mg ya mankhwala patsiku. Mu phukusi la Saksenda muli zolembera 5 za 18 mg zosakanikira zilizonse, 90% ya Liragludide - ndendende mwezi wonse. Mtengo wapakati mumasitolo amakankhwala ndi ma ruble 25,700. Mtengo wa chithandizo ndi Saksenda ndiwokwera pang'ono kuposa mzake: 1 mg ya Lyraglutide ku Saksend imawononga ma ruble 286, ku Viktoz - 264 rubles.

Kodi Liraglutid amagwira ntchito bwanji?

Matenda a shuga amadziwika ndi polymorbidity. Izi zikutanthauza kuti aliyense wodwala matenda ashuga ali ndi matenda angapo omwe ali ndi vuto limodzi - matenda a metabolic. Odwala nthawi zambiri amapezeka kuti ali ndi matenda oopsa, atherosulinosis, matenda a mahomoni, odwala oposa 80% ndi onenepa kwambiri. Ndi kuchuluka kwa insulini, kuchepa thupi kumakhala kovuta kwambiri chifukwa chokhala ndi njala nthawi zonse. Anthu odwala matenda ashuga amafunikira chakudya champhamvu kuti atsate zakudya zamafuta ochepa. Liraglutide amathandizira osati kuchepetsa shuga, komanso kuthana ndi kulakalaka kwa maswiti.

Zotsatira za kumwa mankhwalawa malinga ndi kafukufuku:

1. Kutsika kwapakati pa hemoglobin wa glycated mu odwala matenda ashuga otenga 1.2 mg wa Lyraglutide patsiku ndi 1.5%. Mwa ichi, mankhwalawa ndi abwino osati amachokera ku sulfonylurea, komanso kwa sitagliptin (mapiritsi a Januvia). Kugwiritsa ntchito liraglutide kokha komwe kumatha kulipirira shuga mu 56% ya odwala. Kuphatikizidwa kwa mapiritsi a kukana insulin (Metformin) kumawonjezera mphamvu ya mankhwalawa.
2. Kusala shuga kumatsika kuposa 2 mmol / L.
3. Mankhwala amalimbikitsa kuchepa thupi. Patatha chaka cholamulira, kulemera kwa odwala 60% kumachepera kuposa 5%, mu 31% - ndi 10%. Ngati odwala amatsatira zakudya, kuchepa thupi kwambiri. Kuchepetsa thupi kumapangidwira makamaka kuchepetsa kuchuluka kwa mafuta a visceral, zotsatira zabwino zimawonedwa m'chiuno.
4. Liraglutide amachepetsa kukana kwa insulini, chifukwa chomwe glucose amayamba kusiya ziwiya mwachangu, kufunika kwa insulini kumachepa.
5. Mankhwalawa amachititsa kuti pakhale masisitere a hypothalamus, potero amachepetsa kumverera kwanjala. Chifukwa cha izi, zopatsa mphamvu za tsiku ndi tsiku za chakudya zimatsika zokha pafupifupi 200 kcal.
6. Liraglutide amakhudza pang'ono kupanikizika: pafupifupi, amachepetsa ndi 2-6 mm Hg. Asayansi amati izi zimapangitsa kuti mankhwalawa akhale othandizira pa makhoma a mitsempha yamagazi.
7. Mankhwalawa ali ndi katundu wa mtima, amakhala ndi zotsatira zabwino zama lipids zamagazi, kutsitsa cholesterol ndi triglycerides.

Malinga ndi madokotala, Liraglutid ndiwothandiza kwambiri poyambira matenda ashuga. Kuika koyenera: Wodwala yemwe amamwa mapiritsi a Metformin pamtengo wokwanira, kukhala ndi moyo wakhama, kutsatira zakudya. Ngati matendawa sakulipiridwa, sulfonylurea mwachikhalidwe imawonjezeredwa ku njira yolandirira, yomwe imatsogolera ku kukula kwa matenda ashuga. Kusintha mapiritsiwa ndi Liraglutide kumapewe kuyipa kwa maselo a beta, ndikulepheretsa kuwonongeka koyambirira kwa kapamba. Maphatikizidwe a insulin samachepa pakapita nthawi, mphamvu ya mankhwalawa imakhala yosasintha, kuwonjezereka kwa mankhwalawa sikofunikira.

Mukasankhidwa

Malinga ndi malangizo, Liraglutid adalembedwa kuti athetse ntchito zotsatirazi:

• kulipira shuga. Mankhwala atha kumwa mankhwalawa pamodzi ndi mapiritsi a insulin ndi hypoglycemic omwe amapezeka m'magulu a biguanides, glitazones, sulfonylureas. Malinga ndi malingaliro apadziko lonse lapansi, Ligalutid wa matenda a shuga amagwiritsidwa ntchito ngati mankhwala a mizere iwiri. Maudindo oyamba akupitilizidwa ndi mapiritsi a Metformin. Liraglutide monga mankhwala okhawo amangokhazikitsidwa ndi kusalolera kwa Metformin. Chithandizo chimathandizidwa ndi masewera olimbitsa thupi komanso zakudya zochepa zama carb;
• kuchepetsa chiopsezo cha kugwidwa ndi matenda a mtima ndi odwala matenda ashuga. Liraglutide imatchulidwa ngati njira yowonjezera, ikhoza kuphatikizidwa ndi ma statins;
• kukonza kwa kunenepa kwambiri kwa odwala omwe alibe shuga ndi BMI pamtunda wa 30;
• chifukwa cha kuchepa thupi kwa odwala omwe ali ndi BMI pamwambapa 27, ngati atapezeka ndi matenda amodzi omwe amapezeka ndi matenda a metabolic.

Zotsatira za liraglutide pa kulemera zimasiyana kwambiri mwa odwala. Poyerekeza ndi kuyesa kunenepa, ena amatsika makilogalamu, pomwe ena amakhala ndi zotsatira zochepa, mkati mwa 5 kg. Onaninso momwe Saksenda adatengedwera kutengera zotsatira za chithandizo cha miyezi 4. Ngati pofika nthawi imeneyi, kuchepera kwa 4% yalemu, kuchepa thupi mwa munthu wodwala sikungachitike, mankhwalawa amayimitsidwa.

Ziwerengero za anthu ochepera thupi malinga ndi zotsatira za mayeso apachaka zimaperekedwa mu malangizo ogwiritsira ntchito Saksenda:

Popeza kuti jakisoni ndi ndalama zingati, mankhwalawa amayamba kuchepa thupi. Lyraglutidu ndi zotsatira zake zoyipa zamagetsi m'mimba sizimawonjezera kutchuka.

Zotsatira zoyipa

Zambiri zoyipa zimakhudzana mwachindunji ndi kapangidwe kamankhwala. Chifukwa chakuchepa kwa chimbudzi cha chakudya m'milungu yoyamba ya mankhwala ndi Lyraglutide, zotsatira zoyipa za m'mimba zimawonekera: kudzimbidwa, kutsegula m'mimba, kupangika kwa mpweya, kupweteka, kupweteka chifukwa cha kuphuka. Malinga ndi ndemanga, kotala la odwala amamva mseru wosiyanasiyana. Kukhala bwino kumakonda kupitilira nthawi. Pambuyo pa miyezi isanu ndi umodzi ya kudya pafupipafupi, 2% yokha ya odwala amadandaula ndi mseru.

Kuchepetsa zotsatirazi, thupi limapatsidwa nthawi yoti lizolowere Liraglutid: mankhwalawa amayamba ndi 0,6 mg, mlingo umachulukitsidwa pang'ono pang'ono. Khansa ya m'mimba siyimakhudza chikhalidwe cha ziwalo zolimbitsa thupi. Mu zotupa matenda am'mimba thirakiti, kukhazikitsa liraglutide ndi koletsedwa.

Zotsatira zoyipa za mankhwala omwe afotokozedwa mu malangizo:

Odwala omwe ali ndi matenda a chithokomiro, zotsatira zoyipa za mankhwalawa zimadziwika. Tsopano Liraglutid akupitilizanso mayeso ena kupatula kugwirizana kwa kumwa mankhwalawo ndi khansa ya chithokomiro. Mwayi wogwiritsa ntchito liraglutide mwa ana ukuphunziridwanso.

Mlingo

Sabata yoyamba ya liraglutide imayendetsedwa pa mlingo wa 0,6 mg. Ngati mankhwalawa amalekeredwa bwino, patatha sabata limodzi mlingo umawonjezeredwa. Zotsatira zoyipa zikagwera, amapitilirabe jakisoni wa 0.6 mg kwakanthawi mpaka amve bwino.

Mlingo wowonjezeredwa pamlingo wowonjezera ndi 0,6 mg pa sabata. Mu shuga mellitus, mulingo woyenera kwambiri ndi 1,2 mg, upamwamba - 1,8 mg. Mukamagwiritsa ntchito Liraglutide kuchokera kunenepa kwambiri, mlingo umasinthidwa kukhala 3 mg mkati mwa masabata asanu. Kuchuluka izi, Lyraglutide amawayamwa miyezi 4-12.

Momwe mungapangire jakisoni

Malinga ndi malangizowo, jakisoni amapangidwa mosalunjika m'mimba, mbali yakunja ya ntchafu, ndi mkono wam'mwamba. Tsamba la jakisoni lingasinthidwe popanda kuchepetsa mphamvu ya mankhwalawo. Lyraglutide ndi jekeseni nthawi yomweyo. Ngati nthawi yoyendetsayo yasowa, jakisoni ikhoza kuchitika mkati mwa maola 12. Ngati zambiri zadutsa, jakisoniyu akusowa.

Liraglutide ili ndi cholembera, chosavuta kugwiritsa ntchito. Mlingo wofunikira ukhoza kuyikidwa pa dispenser.

Momwe mungapangire jakisoni:

• chotsani filimu yoteteza ku singano;
• chotsani kapu m'manja;
• ikani singano pachikhathocho potembenuza mosakhalitsa;
• chotsani kapu ku singano;
• tembenuza gudumu (mutha kutembenukira mbali zonse) za kusankha kwa mankhwalawo kumapeto kwa chogwirira mpaka malo omwe mukufunako (mlingowo udzawonetsedwa pazenera);
• ikani singano pansi pa khungu, chogwirira chimakhala chowongoka;
• kanikizani batani ndikuyigwira mpaka 0 itawonekera pazenera;
• chotsani singano.

Analogs a Liraglutida

Chitetezo cha Patent cha Liraglutide chimatha mu 2022, mpaka nthawi iyi sikoyenera kuyembekezera mawonekedwe akuwoneka ngati otsika mtengo ku Russia. Pakadali pano, kampani yaku Israeli Teva ikuyesayesa kulembetsa mankhwala omwe ali ndi zomwezi, zomwe zimapangidwa ndiukadaulo wake. Komabe, NovoNordisk imatsutsa mwamphamvu mawonekedwe a generic. Kampaniyo akuti njira yopangirayo ndiyovuta kwambiri kotero sizingatheke kukhazikitsa kufanana kwa analogues. Ndiye kuti, atha kukhala mankhwala omwe ali ndi ntchito yosiyaniratu ndi zina kapena kuperewera kwa zinthu zofunika.

Ndemanga