Hypoglycemic mankhwala a odwala matenda ashuga Januvia

Type 2 matenda a shuga a 90% amitundu yonse ya matenda ashuga. Mbali imodzi, kukana insulini kumapangitsa kuti maselo asayankhe pafupipafupi ndi insulin. Kumbali ina, pali kusowa kwa ma cell a a-cell: kuchokera kuphwanya kwa plasticity mpaka kufa kwathunthu, ndipo odwala matenda ashuga kuchuluka kwawo kumatsitsidwa ndi 63% (mwa owonda - ndi theka pang'ono). Zonsezi sizimalola thupi kudzaza zofunikira zamahomoni kwathunthu kuthana ndi insulin.

Kuti athane ndi gulu loyipa ili, mankhwala ambiri apangidwira kuthana ndi glycemic. Biguanides ndi thiazolidinediones amalimbana ndi insulin kukana, sulfonylureas ndi zinthu zadongo zomwe zimapangitsa kuti kaphatikizidwe kamene kamakhala ndi insulin, Acarbose ndi Glucobay amatseketsa kuyamwa kwa glucose m'matumbo, koma kuwonjezera pa kugwiranso ntchito, palinso vuto lachitetezo. Makamaka, ambiri aiwo amawononga kulemera kwa thupi, pomwe kunenepa kwambiri ndi chifukwa chachikulu cha matenda ashuga 2.

M'badwo waposachedwa wa mankhwala ndi mndandanda wamankhwala ampretin. Inhibitor DPP-4 Januvia (dzina lapadziko lonse - Sitagliptin, Januvia, Sitagliptin) satenga nawo gawo pankhaniyi - amachepetsa kulakalaka, komanso nthawi yayitali - komanso kulemera, ndipo si mwayi wokhawo.

Pazaka zopitilira 10 zochita zamankhwala, umboni wokwanira wachitachita wapezeka.

Mlingo wa mawonekedwe ndi kapangidwe kake

Chithunzi cha Janucius incretin mimetic, chithunzi chake chomwe chaperekedwa m'gawoli, chimapangidwa pamaziko a sitagliptin, omwe amaperekedwa mwanjira ya phosphate monohydrate. Kugwiritsidwa ntchito pamapiritsi osiyanasiyana ndi mafilimu osiyanasiyana: magnesium, cellcrystalline cellulose, sodium, calcium hydrogen phosphate.

Anthu odwala matenda ashuga amatha kusiyanitsa kuchuluka kwa mankhwalawa mu utoto: ndi mlingo wochepa - pinki, wokhala ndi mtengo wambiri - beige. Kutengera kulemera, mapiritsiwo amalembedwa: "221" - mlingo 25 mg, "112" - 50 mg, "277" - 100 mg. Mankhwalawa amadzaza m'matumba otupa. Pakhoza kukhala matuza angapo m'bokosi lililonse.

Pa boma lotentha lofika 30 ° C, mankhwalawa amatha kusungidwa mkati mwa nthawi yovomerezeka (mpaka chaka).

Momwe Januvia amagwirira ntchito

Mankhwala opangidwa a hypoglycemic ndi a gulu la ma incretin mimetics omwe amaletsa DPP-4. Kugwiritsa ntchito pafupipafupi kwa Januvia kumawonjezera kupanga ma insretin, kumalimbikitsa ntchito yawo. Kupanga kwamkati mwa insulin kumachulukitsa, kaphatikizidwe ka glucagon mu chiwindi kumachepetsa.

Kuwongolera kwamlomo kumalepheretsa kuwonongeka kwa glucagon-monga peptide ya gluc-1, yomwe imagwira gawo labwino pakukhazikitsa insulini yodalira shuga, ndikuyambiranso kuzungulira kwazinthu zathupi. Njira izi zimathandizira kuti glycemia ikhale yachilendo.

Sitagliptin imathandizira kuchepetsa hemoglobin wa glycated, glucose othamanga, komanso kulemera kwa thupi. Kuchokera pamimba yamagaya, mankhwalawa amalowetsedwa m'magazi mkati mwa maola 1-4. Nthawi ya ingestion ndi kuchuluka kwa chakudya cha caloric sikukhudza pharmacokinetics ya inhibitor.

Mankhwalawa ndi oyenera kutsatiridwa nthawi iliyonse yoyenera: musanadye, mutamaliza kudya komanso musanadye. Mpaka 80% ya yogwira pophika imapukutidwa ndi impso. Mankhwalawa angagwiritsidwe ntchito onse mu monotherapy komanso mu zovuta za chithandizo cha matenda a shuga a 2, makamaka ngati chiwopsezo cha hypoglycemic chikuwonjezeka.

Mu chiwembu chokhazikika, Januvia amathandizidwa ndi Metformin, zakudya zotsika zamatumbo komanso ochita masewera olimbitsa thupi.

Mutha kuwona momwe magwiritsidwe amakhudzidwe a mankhwalawa pavidiyoyi:

Yemwe amawonetsedwa mankhwalawo

Januvia amalembedwa mtundu wa matenda ashuga amitundu iwiri pamagawo osiyanasiyana owongolera matenda.

Akaphatikizidwa ndi mankhwala ena a hypoglycemic, Januvia amalembedwa:

• Kuphatikiza pa Metformin, ngati kusintha kwa moyo sikunabweretse zotsatira zomwe zikuyembekezeka;
• Pamodzi ndi zotumphukira za gulu la sulfonylurea - Euglucan, Daonil, Diabeteson, Amaril, ngati chithandizo cham'mbuyomu sichinali chokwanira kapena wodwalayo samalekerera Metformin;
• Kufanana ndi thiazolidinediones - Pioglitazan, Rosiglitazone, ngati kuphatikiza koteroko kuli koyenera.

Mankhwala atatu, Januvius amaphatikizidwa:

• Ndi Metformin, zotumphukira za sulfonylurea, zakudya zamagetsi otsika ndi masewera olimbitsa thupi, ngati popanda Januvia sizingatheke kukwaniritsa 100% glycemic control;
• Nthawi yomweyo Metformin ndi thiazolidinediones, PPARy olimbana nawo, ngati matenda ena oyendetsa matenda sanakhale othandiza mokwanira.

Ndizotheka kugwiritsa ntchito Januvia kuwonjezera pa insulin mankhwala ngati mankhwalawa athetsa vuto la kukana insulin.

Ndani sayenera kutumizidwa sitagliptin

Ndi matenda amtundu wa 1 shuga ndi ziwopsezo zomwe zimapangidwa ndimomwe zimapangidwira, Januvia adatsutsana. Osatipatsa mankhwala:

1. Amayi oyembekezera komanso oyembekezera;
2. Ndi matenda ashuga ketoacidosis;
3. Muubwana.

Odwala omwe ali ndi aimpso pathologies poika Januvia ayenera kuwonjezeredwa chidwi. Woopsa mawonekedwe, ndibwino kusankha analogi mankhwala. Odwala pa hemodialysis amayang'aniridwa nthawi zonse.

Kukhoza kwamavuto

Pankhani ya bongo, hypersensitivity, osankhidwa bwino mankhwalawa, zotsatira zosafunikira zitha kuoneka ngati zochulukitsa za matenda omwe alipo kapena kukula kwa atsopano. Zochitika zoterezi ndizothekanso chifukwa chogwirizana ndi zovuta za mankhwala omwe munthu wodwala matenda ashuga amalandira.

Pakati pa zovuta za matenda ashuga, pali mitundu yovuta yamatenda (diabetesic ketoacidosis, precoma ndi glycemic coma) komanso yayitali - angiopathy, neuropathy, retinopathy, nephropathy, encephalopathy, ndi zina zotero. Nephropathy ndiyofunikira kwambiri pakulephera kwa impso - 44% ya milandu pachaka, neuropathy ndiyomwe imayambitsa kukhumudwa kosadukiza kwazovuta (60% ya milandu yatsopano pachaka).

Ngati malingaliro a dokotala pokhudzana ndi kuchuluka ndi nthawi yavomerezekayo satsatiridwa, zovuta za dyspeptic ndi zovuta zamatumbo zimayambira.

Zotsatira zina zoyipa, kufooka kwa chitetezo chathupi kumachitika nthawi zambiri, limodzi ndi matenda opatsirana thirakiti.

Za mankhwala a Januvia mu ndemanga, odwala matenda ashuga amadandaula za kupweteka kwa mutu komanso kutsika kwa magazi. Pazowunikira, kuwerengera kwa leukocyte kumatha kuwonjezeka pang'ono, koma madokotala sawona kuti izi ndizofunikira. Palibe mgwirizano wodalirika pakati pa kumwa mankhwalawa ndi kukula kwa kapamba.

Pogwiritsa ntchito nthawi yayitali ya sitagliptin, zosokoneza kuchokera mu mtima, mitsempha yamagazi, ndikupanga magazi ndizotheka. Wodwala matenda ashuga ayenera kudziwitsidwa za kufunika kokachezera dokotala ngati kusintha kwa kuthamanga kwa magazi kapena kugunda kwa mtima pamene mukumwa Januvia.

Sipanakhalepo milandu yosokoneza mankhwalawa machitidwe azachipatala; kusintha kosakwanira kwaumoyo, kungogwira kwake ntchito kochepa ndizotheka.

Milandu yambiri

Januvia ndi mankhwala oopsa, ndipo kutsatira kwambiri malangizo a endocrinologist ndiye vuto lalikulu. Mtengo woyambira wotetezeka wa sitagliptin ndi 80 mg.

Kafukufuku wokhudzana ndi bongo wa bongo anachitika ndi kuwonjezeka kakhumi pa mlingo uwu.

Ngati vuto la hypoglycemic litayamba, wolakwiridwayo amadandaula mutu, kufooka, matenda osokoneza bongo, kuipira kwa thanzi, ndikofunikira kutsuka m'mimba, kupatsa wodwalayo mankhwala othandiza. Chithandizo cha Syndrome chidzachitika mu chipatala cha matenda ashuga.Milandu yama bongo osokoneza bongo amalembedwa kawirikawiri. Izi zimakonda kuphatikizidwa ndi tsankho la munthu payekha kapena chifukwa cha mankhwala ena omwe amagwiritsidwa ntchito popanga zovuta.

Hemodialysis ya Januvia siyothandiza. Kwa maola 4, pomwe njirayi imatha, mutamwa kamodzi, 13% yokha ndi yomwe idatulutsidwa.

Kuthekera kwa Januvia ndi zovuta mankhwala

Sitagliptin sikuletsa ntchito ya Simvastatin, Warfarin, Metformin, Rosiglitazone. Januvia amatha kugwiritsidwa ntchito ndi amayi omwe amagwiritsa ntchito njira zakulera pakamwa pafupipafupi. Kukhazikika kwapakati pa Dioxin kumathandizira pang'ono kuthekera komaliza, koma kusintha kotereku sikutanthauza kusintha kwa mlingo.

Januvia angagwiritsidwe ntchito limodzi ndi cyclosporine kapena zoletsa (monga ketoconazole). Zotsatira za sitagliptin mu zochitika izi sizowopsa ndipo sizisintha momwe mungamwe mankhwalawa.

Malangizo ogwiritsira ntchito

Mankhwala a Januvia, malangizo ogwiritsira ntchito amapangidwa mwatsatanetsatane, ndipo ayenera kuphunziridwa isanayambike maphunziro.

Ngati nthawi yakuvomerezedwa yaphonya, mankhwalawo amayenera kuledzera nthawi yoyamba. Nthawi yomweyo, kuwerengetsa kawiri kawiri ndizowopsa, popeza payenera kukhala nthawi yotalikirana pakati Mlingo.

Mlingo wofanana wa Januvia ndi 100 mg / tsiku. Mu aimpso aimpso ofatsa kwambiri, 50 mg / tsiku amathandizidwa ngati matendawa akula ndikuwonjezereka, mankhwalawa amasinthidwa kukhala 25 mg / tsiku. Ngati mankhwalawa agwiritsidwa ntchito limodzi ndi mankhwala ena ochepetsa shuga, milingo ya insulin kapena mapiritsi iyenera kuchepetsedwa kuti muchepetse hypoglycemia.

Ngati ndi kotheka, dialysis ikuchitika, pomwe mankhwala osachepera mlingo. Nthawi yolandila Januvia siimakhudzidwa ndi nthawi ya mchitidwe. Paakula (kuyambira zaka 65), odwala matenda ashuga amatha kugwiritsa ntchito mankhwalawa popanda zoletsa zina, ngati pakadalibe zovuta kuchokera ku impso. Potsirizira pake, kusintha kwa mlingo kumafunika.

Malangizo apadera

Yanuvia ikhoza kugulidwa mu chipatala cha mankhwala okha ndi mankhwala. Hypoglycemia, malinga ndi kafukufuku, chithandizo chovuta kwambiri sichachulukanso kuposa placebo. Zotsatira za thupi la Januvia motsutsana ndi kuchuluka kwa insulini sizinaphunzire, kotero odwala ali ndi malire pa kuwongolera kwa hypoglycemic.

Zotsatira zoyipa za mankhwalawa pakutha kuyendetsa kayendedwe kapena njira zovuta sizinalembedwe, popeza kuti gawo la yogwira pakatikati wamanjenje sililetsa.

Edema wa Quincke

Hypersensitivity mukatenga Januvia imatha kufotokozedwa ngati mantha a anaphylactic. Nkhope ya wovutikayo imatupa, zotupa za pakhungu zimatuluka. Mwazovuta kwambiri, edema ya Quincke imawonedwa. Ndi zizindikiro zotere, mankhwalawa amasiya pomwepo ndikupempha thandizo kuchipatala.

Januvia mu zovuta mankhwala amagwiritsidwa ntchito posowa zotsatira zofunika mutatenga Metformin ndi kusintha kwasinthidwe. Muthanso kugwiritsa ntchito mankhwalawa posintha insulin.

Ndemanga za Januvia

Ndi mtundu wa shuga wachiwiri womwe sukudwala popanda mapiritsi ochepetsa shuga, ochepa amatha kuthana ndi poizoni.

Ndikofunikanso kupeza mankhwala anu omwe angakuthandizeni kuthana ndi matenda osachiritsika osawonjezera zovuta zatsopano kwa odwala matenda ashuga.

Mukamasankha mankhwala oyenera a hypoglycemic a kulowererapo kwa matenda ashuga, akatswiri amatchera khutu ku glycemic komanso kuthekera kopanda glycemic. Poyamba, uku ndi kuchepa kwa glycated hemoglobin, chiopsezo cha hypoglycemia, insulin secretion, ndi mbiri yotetezeka. Kachiwiri - kusintha kwa kulemera kwa thupi, HF zowopsa, kulekerera, mbiri yachitetezo, kuthekera, mtengo, kugwiritsa ntchito mosavuta.

About mankhwala a Januvia chiyembekezo chamadokotala: kusala kudya kwa glycemia kuli pafupi ndi kwabwinobwino, kuchuluka kwa gluprose ya postprandial pomwe kudya sikudutsa malire ovomerezeka, madontho a shuga osawonongeka samawonedwa, mankhwalawa ndi otetezeka komanso ogwira ntchito ndipo amakwaniritsa bwino zofunikira. Maganizo a Pulofesa A.S. Ametova, mutu. Dipatimenti ya Endocrinology ndi Diabetesology GBOU DPO RMAPE ya Unduna wa Zaumoyo ku Russian Federation, za mwayi wa sitagliptin, onani vidiyo:

Ndemanga za odwala omwe akutenga Januvia ndi osakanikirana.

A.I. Ndakhala ndili ku Metformin kwa zaka 3 kale, adokotala sanakonde mayeso omaliza, ndidamuwonjezera Januvia. Ndakhala ndikumwa piritsi limodzi kwa mwezi tsopano. Adotolo adati mutha kumwa nthawi iliyonse, koma ndikumva bwino m'mawa. Ndipo mankhwalawa amayenera kugwira ntchito, choyambirira, masana, pomwe katundu pa thupi ndi wokwanira. Sindinazindikire chilichonse chamtsogolo, pomwe akumwabetsa shuga.

T.O. Mtsutso wofunikira pakuyesera thanzi langa ndi mtengo wamankhwala. Kwa Januvia, mtengo wake siwosunga bajeti kwambiri: Ndagula magome 28 a 100 mg kwa ruble 1675. Ndinkakhala ndi zokwanira mwezi umodzi. Mankhwalawa ndi othandizadi, shuga ndi abwinobwino, koma ndikufunika kugula mapiritsi ena, chifukwa chake polingalira penshoni yanga ndikupempha dokotala kuti andilowe m'malo. Mwina wina angauze analogue yotsika mtengo?

Makhalidwe oyerekeza ofanana ndi a Januvia

Ngati tingayerekeze mankhwalawa malinga ndi code ya ATX 4, ndiye m'malo mwa Januvia, mutha kusankha analogues:

• Onglise ndi yogwira pophika saxagliptin;
• Galvus, yopangidwa pamaziko a vildagliptin;
• Galvus Met - vildagliptin kuphatikiza ndi metformin;
• Trazentu ndi yogwira mankhwala linagliptin;
• Combogliz Prolong - yozikidwa pa metformin ndi saxagliptin;
• Nesinu ndi yogwira pophika alogliptin.

Kupanga kwamphamvu kwa mankhwalawa ndikofanana: amachepetsa chilakolako, osalepheretsa dongosolo lamkati lamanjenje komanso mtima. Ngati mungayerekeze analogi ndi Yanuvia pamtengo, ndiye kuti mutha kupeza zotsika mtengo: mapiritsi 30 a Galvus Meta omwe ali ndi mlingo womwewo, muyenera kulipira rubles 1,448, pazidutswa 28 za Galvus - 841 rubles. Onlisa adzagula ndalama zambiri: 1978 rubles for 30 pcs. Mugawo lamtengo womwewo ndi Trazhenta: 1866 rubles. mapiritsi 30. Odula kwambiri pamndandanda uno adzakhala Combogliz Kutalika: 2863 rubles. 30 ma PC.

Ngati sizotheka kupeza chindapusa chochepa cha mtengo wa mankhwala othandizira odwala matenda ashuga, mutha kusankha njira yovomerezeka ndi dokotala.

Masiku ano, matenda a shuga a 2 siwolepheretsa moyo wathunthu. Anthu odwala matenda ashuga amatha kugwiritsa ntchito mankhwala aposachedwa amitundu mitundu paziwonetsero, zida zamankhwala zothandizira kuperekera mankhwala ndikudziyang'anira nokha glycemia. Sukulu za odwala matenda ashuga adapangidwa m'mabungwe azachipatala komanso m'malo ophunzirira, ndipo pali zidziwitso zonse zapaintaneti.

Kodi Januvius ndi piritsi yovomerezeka yatsopano yochizira matenda a shuga a 2 kapena chofunikira mwasayansi.