Liraglutide pankhondo yolimbana ndi kunenepa - malangizo ogwiritsira ntchito

Liraglutide, komanso ma analogue ake ndi mankhwala osiyanasiyana a Viktoz, si mankhwala atsopano. Ku United States, Russia ndi maiko ena komwe mankhwalawo amavomerezedwa mwalamulo, agwiritsidwa ntchito poyang'anira matenda a shuga a 2 kuyambira 2009.

Mankhwalawa a kalasi ya intretin amatha kuthekera kwa hypoglycemic. Kampani yaku Danish Novo Nordisk imapanga liraglutide pansi pa dzina la malonda la Victoza. Kuyambira chaka cha 2015, mu kapeteni wamankhwala, mutha kupeza genx Saxenda.

Onsewa amaikidwa ngati mankhwala ochepetsa thupi kwa achikulire. Amawonetsedwa ndi index yamasamba 30, yomwe imawonetsa kunenepa kwambiri.

Ndizotheka kugwiritsa ntchito mankhwalawa ndi BMI yoposa 27 ngati wodwala ali ndi matenda opatsirana omwe amayamba chifukwa cha kunenepa kwambiri - matenda oopsa, matenda a shuga a 2.

Pambuyo pa 2012, liraglutide ndi mankhwala achinayi onenepa ovomerezeka ku United States. Nutritionist William Troy Donahue waku Denver akufotokoza kuti mankhwalawa adapangidwa ngati chithunzi cha mahomoni a GLP ophatikizidwa m'matumbo, omwe amatumiza zizindikiritso kuubongo. Ichi ndi chimodzi mwazinthu zomwe zimagwira, cholinga chachikulu cha timadzi tating'onoting'ono ndikupanga mnzake ndikuthandizira ma cell a pancreatic pakusintha kwa glucose kukhala mphamvu, osati mafuta.

Kodi mankhwalawa amagwira ntchito bwanji?

Liraglutide mu radar (kaundula wa mankhwala aku Russia) walowa pansi pa mayina amalonda Viktoza ndi Saksenda. Mankhwala ali ndi zigawo zikuluzikulu za liraglutide, zothandizidwa ndi zosakaniza: sodium hydrogen phosphate dihydrate, phenol, sodium hydroxide, madzi ndi propylene glycol.

Monga GLP-2 yachilengedwe, liraglutide imakumana ndi ma receptors, zomwe zimapangitsa kupanga insulin ndi glucagon. Njira za kaphatikizidwe ka mankhwala amkati mwa insulin zimapangika pang'onopang'ono. Njira imeneyi imakuthandizani kuti musinthe glycemia mokwanira.

Mankhwalawa amawongolera kukula kwamafuta amthupi pogwiritsa ntchito njira zomwe zimaletsa njala komanso kugwiritsa ntchito mphamvu. Kuchepetsa thupi mpaka 3 makilogalamu kudalembedwa panthawi ya mayesero azachipatala pogwiritsa ntchito Saxenda panjira yovuta ndi metformin. Kutalika kwa BMI koyambirira koyambirira, kuthamanga kumawadwala odwala.

Ndi monotherapy, voliyumu ya m'chiuno inachepetsedwa ndi 3-3.6 masentimita pachaka chonse, ndipo kulemera kunatsika mpaka madigiri osiyanasiyana, koma mwa odwala onse, mosasamala kanthu za kukhalapo kwa zotsatira zosasangalatsa. Pambuyo poteteza mawonekedwe a glycemic, liraglutide imaletsa kukula kwa maselo a b omwe ali ndi vuto la kapangidwe ka insulin.

Pambuyo pa jekeseni, mankhwalawa amalowetsedwa pang'onopang'ono. Pachimake pazowawa zake zimawonedwa patatha maola 8-12. Kwa pharmacokinetics a mankhwalawa, zaka, jenda kapena kusiyana kwa mafuko satenga mbali yapadera, monga momwe zimakhalira ndi chiwindi ndi impso.

Nthawi zambiri, mankhwalawa amalowa m'magazi ndi jakisoni, kukulitsa kuchuluka kwa peptides, kubwezeretsa kapamba. Chakudya chimatengedwa bwino, zizindikiritso za matenda amtundu wa 2 sizachilendo.

Zoyesa zamankhwala zimachitika mchaka, ndipo palibe yankho lomveka bwino pafunso la nthawi ya mankhwalawa. FDA ilimbikitsa kuyesa odwala miyezi 4 iliyonse kuti asinthe ma regimen.

Ngati munthawi imeneyi kuwonda kumakhala kochepera 4%, ndiye kuti mankhwalawo sioyenera kwa wodwalayo, ndipo m'malo mwake muyenera kufunafuna ena.

Momwe mungathanirane ndi kunenepa kwambiri ndi liraglutide - malangizo

Mlingo wa mankhwala mu mawonekedwe a cholembera umathandizira kuti azigwiritsa ntchito. Syringe imakhala ndi chizindikiritso chomwe chimakupatsani mwayi kuti mupeze mlingo wofunikira - kuchokera ku 0.6 mpaka 3 mg ndi gawo la 0.6 mg.

Mulingo wapamwamba wa tsiku ndi tsiku wa liraglutide malinga ndi malangizo ogwiritsira ntchito ndi 3 mg. Nthawi inayake, kumwa mankhwala kapena chakudya, jakisoni samangidwa. Mlingo woyambira sabata yoyamba ndi wocheperako (0.6 mg).

Pakatha sabata, mutha kusintha zomwe zimasintha mu 0.6 mg. Kuyambira mwezi wachiwiri, pamene kuchuluka kwa mankhwalawa kumafikira 3 mg / tsiku, ndipo mpaka kumapeto kwa maphunzirowo, kulandira mankhwala osokoneza bongo sikumachitika m'njira yowonjezera.

Mankhwalawa amaperekedwa kamodzi pa tsiku lililonse, malo oyenera a thupi la jekeseni ndi m'mimba, mapewa, m'chiuno. Nthawi ndi malo a jakisoni amatha kusinthidwa, chinthu chachikulu ndikuwonetsetsa kuti mulingowu.

Aliyense yemwe alibe chidziwitso chogwiritsa ntchito zolembera yekha amatha kugwiritsa ntchito njira zake.

1. Kukonzekera. Sambani m'manja, chekeni zowonjezera zonse (cholembera chodzazidwa ndi liraglutide, singano ndi mowa wokuta).
2. Kuyang'ana mankhwalawo m'khola. Iyenera kukhala ndi kutentha kwa malo, madzi amakhala owonekera nthawi zonse.
3. Kuyika singano. Chotsani kapu pachiwono, chotsani chizindikiro kunja kwa singano, ndikuchigwira ndi kapu, ndikuyiyika mu nsonga. Kutembenuza ndi ulusi, kukonza singano pamalo otetezeka.
4. Kutha kwa thovu. Ngati mlengalenga muli mpweya, muyenera kuyiyika kuti ikhale magulu 25, chotsani zisoti pachifuwa ndikutembenuzira chimaliziro. Gwedeza syringe kuti mpweya utuluke. Kanikizani batani kuti dontho la mankhwala lituluke kumapeto kwa singano. Ngati palibe madzi, mutha kubwereza njirayi, koma kamodzi.
5. Mlingo woyika. Sinthani batani jakisoni kukhala mulingo wofanana ndi mlingo wa mankhwala omwe dokotala wakupatsani. Mutha kuzungulira mbali iliyonse. Mukazungulira, osakanikiza batani ndikutulutsa. Nambala yomwe ili pawindo iyenera kufufuzidwa nthawi iliyonse ndi mlingo womwe adokotala adapereka.
6. Kubaya Malo omwe ma jakisoni amayenera kusankhidwa limodzi ndi adotolo, koma popanda kusapeza bwino ndibwino kuti musinthe nthawi iliyonse. Tsukani malo a jakisoni ndi swab kapena nsalu yothinikidwa mu mowa, mulole kuti ome. Ndi dzanja limodzi, gwiritsani syringe, ndipo ndi inayo - pangani khungu lanu pamalo omwe adabayira. Ikani singano pakhungu ndikumasulidwa. Dinani batani m'manja ndipo dikirani masekondi 10. Singano imatsala pakhungu. Ndiye chotsani singano mutagwira batani.
7. Cheke. Wonjezani malo opaka jakisoni ndi chopukutira, onetsetsani kuti mankhwalawo alowetsedwa kwathunthu (chizindikiro " Ngati pali chithunzi chosiyana, ndiye kuti sizinakhazikitsidwe mokwanira. Mlingo wosowa umaperekedwanso chimodzimodzi.
8. Pambuyo jekeseni. Chotsani singano yogwiritsidwa ntchito. Gwirani mwamphamvu chovala chija ndikuvala kapu. Potembenuza, vula singano ndi kutaya. Ikani cholembera.
9. Sungani cholembera mumawu ake oyamba. Osasiya singano pathupi, gwiritsani ntchito kawiri, kapena gwiritsani ntchito singano yomweyo ndi anthu ena.

Malangizo a kanema ogwiritsa ntchito cholembera ndi Victoza - pa kanemayu

Mfundo ina yofunika: liraglutide yoonda kuchepa thupi siimalo mwa insulin, yomwe nthawi zina imagwiritsidwa ntchito ndi anthu odwala matenda ashuga omwe ali ndi matenda a mtundu 2. Kuchita bwino kwa mankhwalawa m'gulu la odwala sikunaphunzire.

Liraglutide imaphatikizidwa bwino ndi mankhwala omwe amachepetsa shuga potengera metformin ndipo, mwakutulutsa, metformin + thiazolidcediones.

Ndani amasankhidwa liraglutide

Liraglutide ndi mankhwala oopsa, ndipo ndikofunikira kuti mupeze pokhapokha ngati wodwala azakudya kapena endocrinologist. Monga lamulo, mankhwala amathandizidwa ndi odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda, makamaka pamaso pa kunenepa kwambiri, ngati kusintha kwa moyo kulola kuti matenda asamakhale kwambiri ngati magazi ndi mankhwala osokoneza bongo.

Kodi mankhwalawa amakhudza bwanji kugwira ntchito kwa mita? Ngati wodwala ali ndi matenda ashuga a mtundu wachiwiri, makamaka ngati akumwa mankhwala owonjezera a hypoglycemic, mbiri ya glycemic ikayamba kuchepa. Kwa odwala athanzi, palibe choopsa cha hypoglycemia.

Zitha kuvulaza mankhwala

Liraglutide imatsutsana pokhapokha pakukhudzidwa kwambiri ndi zosakaniza za formula. Kuphatikiza apo, mankhwalawa sanalembedwe:

1. Anthu odwala matenda ashuga omwe ali ndi matenda amtundu 1;
2. Ndi kwambiri matenda a chiwindi ndi impso;
3. Odwala omwe ali ndi vuto la mtima la 3 ndi 4;
4. Ngati mbiri ya kutupa m'mimba;
5. Amayi oyembekezera komanso oyembekezera;
6. Ndi neoplasms ya chithokomiro England;
7. Mu matenda a diabetes ketoacidosis;
8. Odwala omwe ali ndi mitundu yambiri ya endocrine neoplasia syndrome.

Malangizowo samalimbikitsa kutenga liraglutide limodzi ndi jakisoni wa insulini kapena ena okana ndi GLP-1. Pali zoletsa zaka: mankhwalawa saikidwa kwa ana ndi anthu okhwima (atatha zaka 75), popeza maphunziro apadera a gulu ili la odwala sanachitike.

Ngati pali mbiri ya kapamba, mankhwalawa sawonjezedwanso, popeza palibe chidziwitso chachipatala chokhudza chitetezo chake m'gulu ili la odwala.

Kuyesa kwa zinyama kwatsimikizira kuopsa kwa kubereka kwa metabolite, chifukwa chake, pa gawo lokonzekera kubereka, liraglutide iyenera m'malo mwa insal insulin. Poberekera nyama zazikazi, kuchuluka kwa mankhwalawa mkaka kunali kochepa, koma izi sizokwanira kutenga liraglutide pa mkaka wa mkaka.

Palibe zokuchitikirani ndi mankhwalawa ndi ma analogu ena omwe amagwiritsidwa ntchito kukonza kulemera. Izi zikutanthauza kuti ndizowopsa kuyesa njira zosiyanasiyana zochepetsera thupi pochiritsa ndi liraglutide.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri ndizovuta zam'mimba. Pafupifupi theka la odwala amadandaula ndi mseru, kusanza, kupweteka kwa epigastric. Wachisanu aliyense amakhala ndi kuphwanya mtundu wa defecation (nthawi zambiri - kutsegula m'mimba ndi madzi am'mimba, koma akhoza kudzimbidwa). 8% ya odwala omwe amachepetsa thupi amamva kutopa kapena kutopa kosalekeza.

Kuwonetsetsa makamaka momwe aliri ndi njira yochepetsera thupi kuyenera kulipidwa kwa odwala matenda ashuga omwe ali ndi matenda amtundu 2, popeza 30% ya omwe amatenga liraglutide nthawi yayitali amalandila mavuto ena monga hypoglycemia.

Zotsatira zotsatirazi sizachilendo mukamalandira mankhwala:

• Mutu;
• Kukopa, kufalikira;
• Belching, gastritis;
• Anachepetsa chilala mpaka kugona;
• Matenda opatsirana a kupuma;
• Tachycardia;
• Kulephera kwamphamvu;
• Thupi lawo siligwirizana chikhalidwe chakumudzi (mu jekeseni zone).

Popeza mankhwalawa amayambitsa zovuta ndikutulutsidwa kwam'mimba, mawonekedwewa akhoza kuthana ndi mayamwidwe am'magazi ena a mankhwala ena. Palibe kusiyana kwakanthawi kachipatala, motero, palibe chifukwa chosinthira kuchuluka kwa mankhwala omwe amagwiritsidwa ntchito povuta mankhwala.

Bongo

Zizindikiro zazikulu za bongo ndi kukanika kwa msana mu mseru, kusanza, kufooka. Panalibe zochitika za chitukuko cha zochitika za hypoglycemic, pokhapokha ngati mankhwala ena amatengedwa limodzi kuti muchepetse kunenepa.

Malangizo ogwiritsira ntchito liraglutide amalimbikitsa kutuluka kwam'mimba kuchokera ku mankhwala omwe amapezeka kale ndimankhwala ake metabolites pogwiritsa ntchito ma sorbents ndi dalili.

Kodi mankhwala amathandizira bwanji kuti muchepetse kunenepa?

Mankhwala ozikidwa ndi mankhwala opangira liraglutide amathandizira kuchepetsa thupi mwakuchepetsa kuchuluka kwa chakudya m'mimba. Izi zimathandiza kuchepetsa kulakalaka ndi 15-20%.

Kuti muwonjezere mphamvu ya liraglutide pochizira kunenepa, ndikofunikira kuphatikiza mankhwala ndi michere ya hypocaloric. Ndikosatheka kukwaniritsa chithunzi chabwino ndi jakisoni imodzi yokha. Tifunika kuwunika zochita zathu zoyipa, kuchita zovuta kuti zikhale zathanzi komanso zaka zolimbitsa thupi.

Ndi njira yokwanira yothetsera vutoli, 50% ya anthu onse athanzi omwe amaliza maphunziro athunthu komanso kotala la odwala matenda ashuga amachepa. Mugawo loyamba, kuchepa thupi kudalembedwa pafupifupi 5%, wachiwiri - ndi 10%.

Liraglutide - analogues

Kwa liraglutide, mtengo umachokera ku ruble 9 mpaka 27,000, kutengera mlingo. Kwa mankhwala oyamba, omwe amagulitsanso pansi pa dzina la malonda a Viktoza ndi Saksenda, pali mankhwala omwe ali ndi vutoli.

1. Baeta - amino acid amidopeptide yomwe imachedwetsa kuchotsa zonse zam'mimba, imachepetsa chilimbikitso; mtengo wanji wa cholembera ndi mankhwala - mpaka ma ruble 10,000.
2. Forsiga ndi mankhwala amkamwa a hypoglycemic, analog ya liraglutide pamapiritsi amatha kugulidwa pamtengo wokwera ma ruble 280, imagwira ntchito makamaka mukatha kudya.
3. Liksumiya - mankhwala omwe amachepetsa hypoglycemia, osasamala nthawi yakudya; mtengo wa cholembera cha syringe ndi mankhwala - mpaka ma ruble 7,000.
4. NovoNorm - hypoglycemic mkamwa wothandizila ndi yachiwiri mphamvu mu mawonekedwe a kulemera kwamphamvu pamtengo wokwana 250 rubles.
5. Reduxin - jakisoni amachitika kuyambira miyezi itatu mpaka zaka ziwiri. Mtengo wa ma CD umachokera ku ma ruble 1600.
6. Orsoten m'mabotolo amatengedwa ndi chakudya. Mtengo - kuchokera ku ma ruble 200.
7. Diagninide - mapiritsi amatengedwa musanadye. Mtengo wa mankhwalawo umachokera ku ruble 200.

Mapiritsi ngati Liraglutide akhoza kukhala osavuta kugwiritsa ntchito, koma jakisoni wa cholembera wasonyeza kuti ndiwothandiza kwambiri.. Mankhwala othandizira amapezeka. Mtengo wokwera wa mankhwala osangalatsa nthawi zonse umalimbikitsa maonekedwe a nsomba ndi mitengo yokongola pamsika.

Zomwe analogue ndizothandiza kwambiri, ndi adokotala okha omwe angadziwe. Kupanda kutero, chithandizo chamankhwala ndi kuchuluka kwa zotsatira zosayenera sizingachitike.

Ndemanga ndi zotsatira za chithandizo

M'chaka, odzipereka 4800 adatenga nawo mbali pazoyeserera zamankhwala ku USA, 60% ya iwo adatenga 3 mg ya liraglutide patsiku ndipo adataya osachepera 5%. Gawo lachitatu la odwala lidachepetsa 10%.

Akatswiri ambiri sawona kuti zotsatila zake ndizofunika kwambiri kwa mankhwala omwe ali ndi zovuta zingapo. Pa liraglutide, kuwunika kwa kunenepa kwakanthawi kumatsimikizira ziwerengerozi.

Mukutaya thupi ndi Lyraglutide, zotsatira zabwino zimapezeka ndi omwe amathetsa vutoli:

• Amawona zakudya zamagulu ochepa;
• Amakana zizolowezi zoyipa;
• Kuchulukitsa minofu;
• Amapanga malingaliro abwino ndi chikhulupiriro pazotsatira zamankhwala.

Mu Russian Federation, orlistat, sibutramine ndi liraglutide adalembetsa kuchokera pamankhwala ochepetsa. Pulofesa Endocrinologist E. Troshina adaika liraglutide pamalo oyamba pankhani yogwira bwino pamndandanda uno. Zambiri pa kanema