Kuphatikiza mankhwala aku America a Combogliz Prolong

Matenda a diabetes ndi gawo lomwe limakulirakulirabe. M'zaka zaposachedwa, mankhwala ambiri atsopano apangidwa omwe amathandizira kuyang'anira matenda a shuga a 2. Kupita patsogolo kwa zasayansi m'zaka khumi zapitazi kumatchedwa incretin mimetics, komwe kumachepetsa hemoglobin wa glycated ndi 1%. Pankhaniyi, kulemera kwa odwala matenda ashuga kumatsikiranso pang'onopang'ono;

Makhalidwe onsewa (kusalowerera m'ndondomeko ya kulemera kwa thupi, kusakhalapo kwa zovuta zosafunikira, kukhudzika kwakukulu komanso mtengo wotsika mtengo) zimagwiranso ntchito kwa mankhwala othandizira odwala Metformin, omwe akhala akutsogolera kwambiri pakuchiza matenda a shuga a 2 kwazaka zana.

Mankhwala osakanikirana a ku America a Combogliz Prolong amaphatikiza maubwino a metformin ndi incretinomimetics, ndipo mawonekedwe omwe amakhala nthawi yayitali amapereka mwayi wogwiritsa ntchito komanso chitetezo chowonjezera.

Pharmacological mawonekedwe a mankhwalawa

Combogliz Prolong ndi kuphatikiza kwa saxagliptin ndi metformin, kupatsa madokotala ndi anthu odwala matenda ashuga mwayi watsopano wowongolera mbiri yawo ya glycemic.

Saxagliptin

Saxagliptin ndi woimira mankhwala ampretin. Matumbo amapangidwa ndi matumbo pamene zakudya zimalowa. Pali mitundu iwiri ya mahomoni achilengedwe: GLP-1 (glucagon-like peptide) ndi HIP (glucose-insulinotropic polypeptide).

Kulowa m'magazi, amasinthitsa 70% ya insulin ya m'mimba mwa ma cell a β-omwe amachititsa izi.

Mofananamo, ma insretins amalepheretsa kaphatikizidwe ka glucagon ndipo letsa kutulutsidwa kwa zomwe zili m'mimba, ndikupanga njira zina zowonjezera.

Zadziwika kuti odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, kupanga ma ambulensi amkati kumakhala kotsika chifukwa mahomoni amawonongeka mosavuta ndi enzyme DPP-4 (dipeptidyl peptidase). Kuchulukitsa kwa agonists kumalepheretsa zochitika za DPP-4, ndikusunga magwiridwe antchito amkati. Zofanizira zodziwikiratu za GLP-1 sizimvera chidwi ndi izi.

Saxagliptin sikuti imangokulitsa moyo wa ma insretins, komanso imathandizira kukulira kwa ziwerengero zawo mu gawo lakuthupi (kuchuluka kwa nthawi 2). Kutenga ma incretinomimetics kumachepetsa chizindikiro cha kusala kudya ndi glycemia ya postprandial. Izi mawonekedwe a mankhwalawa amatha kuthetsa machitidwe a hypoglycemic.

Metformin

Mankhwala a antihyperglycemic metformin, woyimira yekha pagulu lalikulu, samakhudza maselo a b, motero, samalimbikitsa kutulutsa kwa insulin ndipo samadzaza kapamba.

Amawongolera kusinthasintha kwapansi kwa glycemia poletsa kutulutsa kwa glycogen m'chiwindi ndi 30%. Metformin imalepheretsa kuyamwa kwa mamolekyulu a shuga m'matumbo, kumapangitsa chidwi cha maselo a cell kumadzi awo. Pothamangitsa kayendedwe ka glucose kupita ku minofu, kumawonjezera mphamvu zamagetsi pazofunikira za thupi komanso kumachepetsa shuga la mafuta osasinthika kukhala mafuta.

Metformin yotulutsidwa yosinthika imakhala ndi mwayi wowonjezerapo - zovuta zochepa zoyipa kuchokera m'mimba, kuthana kwa kulemera. Madzi am'mimba otayika, nembanemba imasungunuka mwachangu, kaphatikizidwe kamatupa ndikuphimbidwa ndi gel. Chifukwa cha matrix awa a mankhwalawa, mankhwalawa amamasulidwa mosiyanasiyana tsiku lonse, ndikupereka mawonekedwe a kuyamwa kwakukulu.

Kuphatikiza kwa incretinomimetic ndi metformin kunadziwika ndi madokotala ngati abwino kwambiri pa gawo lililonse la mtundu wa matenda a shuga. Kuphatikiza pa kukhala kosavuta kulandira komanso kukhulupirika kwa wodalirika ku regimen ya chithandizo chotere, njira yayikulu ndiyothandiza kwambiri ndikutsimikiziridwa ngati chitetezo. Kwa odwala matenda ashuga onenepa kwambiri, ichi ndiye chisankho chabwino kwambiri, chifukwa mankhwalawa samathandizira kuti munthu azichita bwino, kukhazikika kwa mtima kulephera, kapamba, ndi oncology.

Kutulutsa mawonekedwe ndi kapangidwe Kombiglyze kutalika

Kampani yopanga mankhwala ku America Bristol-Myers squibb imapanga mankhwala antidiabetesic monga mapiritsi okhala ndi utoto wokhala ndi kuthekera kosintha.

Kapisozi iliyonse imakhala ndi 500 kapena 1,000 mg wa zosakaniza za Metformin ndi 2,5 kapena 5 mg wa Saxagliptin. Kuphatikiza pazophatikizira zoyambira, kapangidwe kake kamathandizidwa ndi mafilimu: magnesium stearate, sodium carmellose, hypromellose. Mtundu wa chipolopolo umatha kukhala wachikasu, pinki kapena beige, kutengera mtundu. Makapisozi amawaunjikira m'maselo a aluminium foil blister. Bokosi la makatoni limatha kukhala ndi mbale 488 zotere.

Tulutsani mankhwala omwe mumalandira. Pa Combogliz Chulukitsani mtengo wake umadalira mlingo: 1000 mg + 5 mg (mapiritsi 28) - mpaka 3250 rubles .; 1000 mg + 2,5 mg (mapiritsi 56 pa paketi iliyonse) - mpaka 3130 ma ruble.

Moyo wa alumali wamankhwala ulinso woposa zaka zitatu. Mankhwala omalizira ayenera kutayidwa. Mankhwala safuna mikhalidwe yapadera kuti asungidwe.

Kutalika kwa Combogliz: malangizo ogwiritsira ntchito

Dokotala amasankha dongosolo la kayendetsedwe ndi kumwa payekhapayekha payekha, poganizira zomwe zimayimira glucometer, thanzi labwino, msinkhu wa odwala matenda ashuga, momwe munthu angamve pamapiritsi. Mwambiri, malangizowa amapereka malingaliro amenewo.

Mankhwala okhazikika nthawi zambiri amatengedwa 1 r / tsiku. nthawi yomweyo.

Imwani piritsi m'mawa kapena madzulo, osakupera. Kwa mitundu yosinthika yosinthidwa, kukhulupirika kwa zigoba kumatenga gawo lalikulu.

Mlingo wake ndiwofanana, ngati kuyambira kungakhale piritsi limodzi (500 mg ya metformin + 2,5 mg wa saxagliptin), ngati chiwongolero chonse cha glycemic sichingatheke, mlingo umakulitsidwa mapiritsi 2 (1000 mg ya metformin + 5 mg ya saxagliptin).

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala pochiza matenda ophatikizika, zotsatira za kuyanjana kwawo ziyenera kukumbukiridwa. Makamaka, ndi munthawi yomweyo makina a zoletsa za CYP3A4 / 5 isoenzymes (Indinavir, Ketoconazole, Nefazodon, Itraconazole, Atazanavir), muyezo wochepa wa saxagliptin ndi mankhwala - 2.5 mg.

Mankhwala motengera metformin yokhala ndi zotsatira zazitali zosakhudzana ndi zovuta zam'mimba ndizochepa kwambiri poyerekezera ndi kutulutsidwa mwachangu. Momwe thupi limasinthira kwatsopano, sizopweteka m'mimba Mlingo titration zizichitika pang'onopang'ono, milungu iwiri iliyonse.

Kusintha kwina kulikonse kwamikhalidwe kuyenera kukumbukiridwa mukakonza momwe mankhwalawo amathandizira, motero ndikofunikira kudziwitsa adokotala za iwo munthawi yake.

Analogs Kombiglyce Prolong

Kwa Combogliz Prolong, analogue yokhala ndi zosakaniza zofananira zingakhale Comboglis XR, yomwe imapangidwa ku Italy ndi UK. Mtengo wa analogue umachokera ku 1650 rubles. (Mapiritsi 28 a 1000 mg a metformin ndi 2,5 mg wa saxagliptin).

Zotsatira zochiritsira zophatikizika za Avandamet, Yanumet, Glimecomb, GalvusMet ndi Bagomet kuphatikiza ndizochiritsanso.

Lemberani mankhwala potengera gawo limodzi logwira ntchito monga Glyformin Prolong, Glucofage, Metadiene, Sofamet, Diaformin Od, Ongliza, Matospanin, Metfogamma, Siofora.

Ndani akuwonetsedwa mankhwalawo

Kutalika kwa Combogliz ndikolembedwera mtundu wa matenda ashuga a 2 kuti achepetse kuwongolera kwa glycemic monga chowonjezera pa chakudya chochepa cha carb ndi zochitika zolimbitsa thupi zokwanira, ngati kusintha kwamachitidwe sikupereka zotsatira zomwe mukufuna komanso kuphatikiza kwa saxagliptin ndi metformin ndikoyenera kwa wodwalayo.

Mtheradi ndi zotsutsana pachibale

Ngakhale mankhwala omwe ali ndi chitetezo chambiri, chomwe ndi Combogliz Prolong, sinafotokozeredwe kuti munthu azitsutsa komanso asakanikirane ndi zosakaniza za formula.

1. Mankhwalawa sawonetsedwa kwa amayi apakati komanso oyembekezera (amasunthidwa kwakanthawi kwa insulin), chifukwa chosowa umboni wokwanira chifukwa chogwira ntchito, samaperekedwa kwa ana.
2. Mankhwalawa sioyenera odwala matenda ashuga omwe ali ndi matenda amtundu 1.
3. Pochita kuwonongeka kwa impso, komanso mikhalidwe yomwe imawakwiyitsa, mankhwalawa sanatumizidwenso.
4. Osagwiritsa ntchito mankhwalawa kuchiza odwala omwe ali ndi matenda omwe amachititsa kufa ndi mpweya wa minofu ya minyewa.
5. Ndi ketoacidosis (mawonekedwe a matenda ashuga) okhala ndi chikomokere kapena opanda kukomoka, mankhwalawa samamwa kwakanthawi.
6. Mapiritsi amathetsedwa panthawi yochita, ndikuvulala kwambiri, kuwotcha kwakukulu. Kuyesedwa kwa X-ray yokhala ndi zikwangwani zokhala ndi ayodini mu diabetes kungawononge impso, motero kumasinthidwanso kukhala insulin. Pazonse, chithandizo cha insulin chimawonetsedwa kwa maola 48 asanafike komanso maola 48 pambuyo pa njirazi, makamaka, zonse zimatengera momwe impso ili komanso thanzi la wodwalayo.
7. Ma pathologies a chiwindi, lactic acidosis ndi kudalira mowa amakhalanso pamndandanda wa contraindication. Simungathe kupereka mankhwalawa kwa odwala omwe ali ndi chibadwa cha galactose.

   
   

Chidwi chachikulu chiyenera kuperekedwa kwa odwala matenda ashuga okalamba, makamaka kuperewera kwa chakudya, kapamba ndi masewera olimbitsa thupi omwe angayambitse hypoglycemia.

Zotheka zosafunikira komanso mankhwala osokoneza bongo ambiri

Saksagliptin wokhala ndi mitundu yosiyanasiyana yothekera amatha kuyambitsa mikhalidwe:

• Sinusitis
• Migraines
• Kupweteka kwam'mimba;
• Kubweza;
• Matenda amitsempha;
• Kusokonezeka kwa kayendedwe ka matumbo;
• Supombocytopenia;
• Nasopharyngitis;
• Hypoglycemia;
• Gastroenteritis;
• Kutupa kumaso;
• Pancreatitis
• Urticaria.

Kafukufuku wa Laborator awonetsa kuchepa kwa mayamwidwe a Vitamini B12 ndikugwiritsa ntchito mankhwalawa kwa nthawi yayitali, komanso kuchepa kwa kuchuluka kwa ma lymphocyte. Milandu yamankhwala osokoneza bongo ndi osakwatiwa, nthawi zambiri amapezeka ndi kugwiritsa ntchito nthawi yayitali saxagliptin. Mankhwalawa sayambitsa kuledzera, ndi kuchuluka kwa mankhwalawa, hemodialysis imagwira. Mofananamo, chithandizo chamankhwala chimachitika.

Mankhwala osokoneza bongo a metformin ndi ochulukirapo, oopsa kwambiri ndi lactic acidosis.. Mutha kuzindikira vutoli pogwiritsa ntchito zizindikiro izi:

1. Kutha;
2. Kufupika;
3. Kupweteka kwam'mimba;
4. Kuthamanga kwa magazi;
5. Hypothermia;
6. Minofu kukokana;
7. Kusokonezeka kwa mtima.

Panthawi yovuta, kusokonezeka kwa chikumbumtima, kukomoka, kukhazikika mtima komanso kukhazikika. Wovutikayo amafunikira kuchipatala mwachangu, popanda chithandizo chokwanira, amatha kumwalira. Metformin yowonjezera imachotsedwanso ndi hemodialysis, ndikofunikira kulingalira kuti clearinine chilolezo chimafikira 170 ml / min.

Munthu wodwala matenda ashuga akamakwaniritsa malingaliro onse a dokotala, amachepetsa chiopsezo chovuta kwambiri. Pankhani ya Combogliz yotalikirapo, sizovuta kutsatira dongosolo la mankhwalawa.

Zosankha zothandizira kucheza ndi mankhwala ena

Mukamapangira njira ya mankhwala a Combogliz Prolong, ndikofunikira kuchenjeza endocrinologist za mankhwala onse omwe munthu wodwala matenda ashuga amatenga pofuna kuchiza matenda oyanjana. Ena mwa iwo amatha kupititsa patsogolo mphamvu zowonjezera shuga ku Comboglize, ena akuletsa ntchito yake.

Kuti mudziwe zambiri, mutha kuyang'ana patebulo.

Amprenavir, Diltiazem, Erythromycin, Fluconazole, Aprepitant, Verapamil, madzi a mphesa, Ketoconazole, mankhwala a sulfonylurea, Glibenclamide, Ketoconazole, CYP3A 4/5 isoenzymes, Famotidine
Othandizira a Cationic, Furosemide, mankhwala opangidwa ndi ethanol, Nifedipine

Ndizachidziwikire kuti kuyesa kudzifufuza komanso kudzipatsa mankhwala ndi Combogliz Prolong kumatha kukhala ndi zotsatirapo zoyipa m'moyo.

Kutalika kwa Combogliz: ndemanga za anthu odwala matenda ashuga

Madokotala omwe amawunika momwe mankhwalawo amathandizira ndi mankhwala a Combogliz Pronge amawona kuti ndi osiyana, ndipo odwala matenda ashuga nawonso amakayikira momwe angachitire.

Kuwongolera kwathunthu kwa matenda ashuga kumafuna njira yolumikizira: zakudya zamafuta ochepa, kuwonetsetsa tsiku ndi tsiku kuwerenga kwa glucometer, masewera olimbitsa thupi mokwanira ndi thandizo lachipatala. Kuphatikiza uku kokha komwe mungathe kuwerengera 100% zotsatira za Combogliz Prolong.

Mu kanemayo, pulofesa-endocrinologist A.S. Ametov amalankhula za mfundo zamakono zoyendetsera matenda a shuga a 2.