Galvus ndi othandizira a hypoglycemic omwe amapanga kuti azilamulira matenda a shuga a mtundu 2. Gawo loyambirira la mankhwalawa ndi vildagliptin. Mankhwala amamasulidwa monga mapiritsi. Madokotala komanso odwala matenda ashuga adalandila ndemanga zabwino kuchokera kwa Galvus.
Imayendetsa mwamphamvu kagayidwe ka insulin ndi glucagon. European Antidiabetesic Association imati Galvus mu monotherapy ndikofunikira kuti agwiritse ntchito pokhapokha ngati metformin itaperekedwa kwa wodwala. Kwa odwala matenda a shuga omwe amadalira insulin omwe ali ndi matenda amtundu wa 2, Galvus amathandizira kuchepetsa kuchuluka kwa poplites ndi kuchuluka kwa insulin.
Zotsatira za pharmacological
Mahomoni amatchedwa mahomoni omwe matumbo amatulutsa pamene michere ilowa. Ma mahomoni awa ndi insulinotropic, amachititsa kuti insulini isungidwe, chifukwa 60% yake imapangidwa ndendende chifukwa cha mphamvu ya ma insretin. Izi zimapezeka mu 1960, ataphunzira kudziwa kuchuluka kwa insulin.
Glucan-peptide-1 (GLP-1) ndiodziwika kwambiri, chifukwa ndimatenda a shuga ochepa. Izi zidapangitsa kuti pakhale gulu latsopano la mankhwala omwe amalimbikitsa zomwe zili mumahomoni otero mwina ndi jakisoni wa analogue yopanga ya GLP-1, monga Baeta kapena Victoza, kapena kudzera pakamwa monga Galvus kapena analogue Januvius. Ma Dhib-4 ma inhibitors samangokulitsa kuchuluka kwa mahomoni onse, komanso kupewa kutsika kwawo.
Ndani akuyenera Galvus
Kwa odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, mankhwalawa angagwiritsidwe ntchito:
- Kwa monotherapy, kuphatikiza ndi zakudya zama carb ochepa komanso minofu yambiri;
- Mankhwala osokoneza bongo ofanana ndi metformin, ngati zotsatira zochokera ku mankhwala amodzi sizokwanira;
- Monga njira ina yofanana ndi ya Galvus yofanana ndi mankhwala ofanana ndi metformin ndi vildagliptin;
- Kuphatikiza kwa othandizira ena a hypoglycemic, ngati njira zam'mbuyomu zamankhwala sizigwira ntchito;
- Monga mankhwala othandizira katatu ndi insulin ndi metformin, ngati zakudya, zolimbitsa thupi ndi insulin ndi metformin sizinali zokwanira.
Malangizo ogwiritsira ntchito
Mlingowo umatsimikiziridwa ndi endocrinologist payekhapayekha, potengera magawo a matendawa komanso momwe thanzi la wodwalayo lilili. Kugwiritsa ntchito mapiritsi sikugwirizana ndi chakudya cham'mawa, chinthu chachikulu ndikumwa mankhwalawo ndi madzi okwanira. Pamaso pa zotsatira zosayembekezereka zam'mimba, ndibwino kugwiritsa ntchito mankhwalawo ndi chakudya.
Ngati matenda a shuga a mtundu wachiwiri aikidwa, Galvus akhoza kupatsidwa nthawi yomweyo. Osatengera mtundu wa chithandizo (zovuta kapena monotherapy), mapiritsi amatengedwa kuchuluka kwa 50-100g / tsiku. Mulingo woyenera kwambiri (100 mg / tsiku) amatengedwa m'magawo akulu a shuga. Pa mankhwala, limodzi ndi ena othandizira a hypoglycemic, 100 mg / tsiku ndi omwe amapatsidwa.
Gawo la 50 g / tsiku. kumwa kamodzi, kawirikawiri m'mawa, mlingo wa 100 mg uyenera kugawidwa mu 2 Mlingo - chimodzimodzi, m'mawa ndi maola a madzulo. Ngati kulandilidwa kwa Galvus kusowa, mapiritsi ayenera kumwedwa nthawi iliyonse, koma malire onse ayenera kuyang'aniridwa.
Ngati ndi monotherapy mungathe kutenga 100 mg / tsiku, ndiye ndi zovuta mankhwala, yambani ndi 50 mg / tsiku, mwachitsanzo, ndi metformin: 50 mg / 500 mg, 50 mg / 850 mg, 50 mg / 100 mg.
Ndi chiphuphu chosakwanira cha shuga, mitundu ina ya mankhwala a hypoglycemic (metformin, insulin, sulfonylurea zotumphukira, ndi zina zotere) zinalembedwanso.
Ngati matenda a impso ndi chiwindi akugwira kale ndi kuphwanya, mulingo wambiri umachepetsedwa mpaka 50 mg / tsiku., Popeza Galvus imachotsedwa impso, ndikupanga mtolo wowonjezera pamtundu wamagulu.
Zizindikiro zosokoneza bongo
Ngati chizolowezi cha tsiku ndi tsiku sichidutsa 200 mg / tsiku, odwala matenda a shuga a Galvus amasamutsidwa popanda zotsatira. Mankhwala osokoneza bongo omwe ali ndi zizindikiro zoyenera amawonedwa akudya mopitirira 400 mg / tsiku. Myalgia (kupweteka kwa minofu) kumawonetsedwa nthawi zambiri, nthawi zambiri - paresthesia (mwa mawonekedwe ofatsa komanso transistor), kutupa, kutentha thupi, milingo ya lipase imachulukanso kuposa VGN.
Ngati mkhalidwe wa Galvus upitilira katatu (600 mg / tsiku), pamakhala chiwopsezo chotupa cha miyendo, paresthesia ndi kuchuluka kwa ALT, CPK, myoglobin ndi protein ya C-reactive. Zotsatira zonse zoyesedwa, ngati zizindikiro, zimasowa pomwe Galvus yathetsedwa.
Galvus: analogues
Malinga ndi gawo la yogwira, mankhwalawa Vildaglympin ndi Galvus Met adzakhala ofanana ndi Galvus, ndipo Januvia ndi Onglisa agwirizana malinga ndi code ya ATX-4. Kafukufuku wa mankhwala ndi kuwunika kwa odwala kwawonetsa kuti mankhwalawa amasinthika kwathunthu.
Zochitika Zosiyanasiyana
Kugwiritsa ntchito kwa Galvus kwa nthawi yayitali kumatha kukhala ndi zotsatirapo zoyipa:
- Mutu ndi kutayika kwa mgwirizano;
- Manja ndi miyendo;
- Matenda a Dyspeptic;
- Khungu, matuza ndi zotupa pakhungu loyipa;
- Kuphwanya miyambo yamatumbo;
- Chitetezo chofooka
- Kusweka ndi kugwira ntchito kwambiri;
- Hepatitis, kapamba ndi matenda ena a chiwindi ndi kapamba;
- Kuzizira komanso kutupa.
Kwa omwe Galvus adayesedwa
Contraindication ogwiritsa ntchito Galvus adzakhala matenda angapo ndi zina.
- Aliyense tsankho kwa zigawo zikuluzikulu za mankhwala, matupi awo sagwirizana;
- Kukhalitsa kwamakina ndi kuwonongeka kwa dongosolo;
- Zinthu zomwe zimayambitsa kuperewera kwa impso (malungo, matenda, kupsinjika, kusanza);
- Matenda a mtima ndi mitsempha yamagazi;
- Mavuto opatsirana;
- Diabetesic ketoacidosis, chikomokere, ndi kholo, pamene matenda ashuga amamasuliridwa kukhala insulin;
- Lactic acidosis, kuchuluka kwa lactic acid;
- Mimba ndi mkaka wa m`mawere;
- Mtundu woyamba wa shuga;
- Kuvutitsidwa mwatsatanetsatane kapena poyizoni wa mowa;
- Zakudya zopatsa mphamvu kwambiri zopezeka ndi calorie za 1000 Kcal / tsiku;
- Kuletsa kwa zaka: mpaka zaka 18, metabolite sakhazikitsidwa, atatha zaka 60 - mosamala;
- Pamaso pa opareshoni (masiku awiri asanafike ndi pambuyo pake), patsiku lamomwe lingayambitse othandizira kapena kuyesa kwa radiographic;
- Chimodzi mwazinthu zovuta kwambiri zotsutsana ndi Galvus ndi lactic acidosis, motero, ndi kulephera kwa chiwindi kapena aimpso, mankhwalawa sanadziwike.
Mu odwala matenda ashuga okalamba, kusuta kwa metformin ndikotheka, izi zimawonjezera kuchuluka kwa zovuta, kotero Galvus imayikidwa kokha moyang'aniridwa ndi achipatala.
Zolemba za Galvus chithandizo cha mitundu ina ya odwala matenda ashuga
Palibe chodalirika chokhudza mphamvu ya mankhwalawa pa thanzi la mayi ndi mwana wosabadwayo, chifukwa chake, panthawi yoyembekezera sichinafotokozedwe. Kuchuluka kwa shuga mwa mayi woyembekezera kumawonjezera mwayi wokhala ndi matenda obadwa nawo ngakhale kufa kwa mwana. Mu matenda a shuga mwa amayi apakati, glycemia nthawi zambiri imadziwika ndi insulin.
Kafukufuku wasonyeza kuti ngakhale mlingo wa Galvus, wopitilira nthawi 200, sizinachititse kusintha kwaumoyo wa mayi wapakati kapena mwana wosabadwayo. Zotsatira zomwezi zidalembedwa ndikugwiritsa ntchito metformin ndi Galvus powerengera 10: 1.
Funso loti kuthekera kwa metabolite kulowa mkaka wa m'mawere sikunaphunzire, chifukwa chake, poyamwitsa, Galvus nayenso sinafotokozedwe.
Zochitika za Galvus chithandizo cha ana odwala matenda ashuga omwe ali ndi matenda amtundu wa 2 (kuchuluka kwa odwala otere akukula mwachangu masiku ano), makamaka, kuchuluka kwakeko ndi zotsatirapo zake zoyipa, sikunaphunziridwe mokwanira.
Chifukwa chake, incretin mu mtundu 2 wa shuga amadziwika kuyambira azaka 18.
Anthu odwala matenda ashuga okalamba (atatha zaka 60) ayenera kuwongolera muyeso wa Galvus ndi magawo ake ofunikira, kuti ngati mukumva zowawa, dziwitsani dokotala nthawi yomweyo. Pakadali pano, chiopsezo cha zovuta ndi zotsatira zosayenerera zimawonjezeka, chifukwa chomwe chimapangitsa kuti azisokoneza.
Malangizo apadera
Odwala matenda ashuga ayenera kudziwitsidwa zonse zomwe zingachitike chifukwa chamankhwala atsopano.
Galvus ndi othandizira odwala matenda ashuga, koma si analogue of insulin. Chifukwa chake, kugwiritsidwa ntchito kwake kumafunikira kuwunikira ntchito ya chiwindi. Izi zitha kufotokozedwanso ndikuti gawo lalikulu la Galvus limathandizira ntchito ya aminotransferases. Kunja, izi sizinafotokozedwe mwazizindikiro zowoneka, koma kusintha kwazomwe zikuchitika mu chiwindi mpaka kukula kwa chiwindi sikutha. Mulimonsemo, odzipereka odwala matenda ashuga ochokera ku gulu lowongolera adawonetsa izi. Pazizindikiro zoyambirira za kupweteka kwa pachimake (kupweteka kwapakati pamimba), mankhwalawa ayenera kuthetsedwa. Ngakhale kubwezeretsanso thanzi la chiwindi, Galvus sikulembedwanso.
Anthu odwala matenda a shuga a Galvus omwe amadalira insulin omwe ali ndi matenda a 2 amaperekedwera limodzi ndi kukonzekera kwa insulin.
Kupsinjika pafupipafupi komanso kuchuluka kwambiri kwamanjenje kumachepetsa mphamvu ya Galvus. Malinga ndi anthu odwala matenda ashuga, nthawi zambiri matupi awo amakomoka komanso amasiya kugonja. Chifukwa chake, kuyendetsa galimoto kapena kugwira ntchito zowopsa pamikhalidwe ngati imeneyi sikulimbikitsidwa.
Asanakhale mayeso amtundu uliwonse, Galvus ndi mawonekedwe ake amayimitsidwa masiku awiri. Osiyanasiyana omwe amagwiritsidwa ntchito pozindikira amakhala ndi ayodini. Kulumikizana ndi vildagliptin, imapanga katundu wowonjezera pa chiwindi ndi dongosolo la excretory. Poyerekeza ndi kuwonongeka kwa machitidwe awo, lactic acidosis imatha kuchitika.
Kalasi yoyamba yakulephera kwa mtima (kupatula kwa NYHA) yokhala ndi minyewa yofewa ya minofu sikufuna kusintha kwa mlingo wa Galvus. Gulu lachiwirili limaphatikizapo kuchepetsa minyewa kuti muchepetse kufupika, kufooka, ndi tachycardia, popeza m'malo opanda phokoso palibe matendawa omwe adalembedwa.
Kuti mupewe chiwopsezo cha hypoglycemia, pamodzi ndi mankhwala ophatikizika ndi sulfonylurea, osankhidwa pang'ono a mankhwalawa amasankhidwa.
Zotsatira Zogwiritsa Ntchito Mankhwala
Mu zovuta za mankhwala othandizira omwe amaphatikizidwa ndi metformin, glibenclamide, pioglitazone, ramipril, amlodipine, digoxin, valsartan, simvastatin, warfarin mpaka Galvus, palibe zotsatira zamankhwala zomwe zidawululidwa ndikuyanjana kwawo.
Kuphatikizika kwa thiazides, glucocorticosteroids, sympathomimetics, mahomoni a chithokomiro amachepetsa mphamvu ya hypoglycemic ya vildagliptin.
Zoletsa za angiotensin-zotembenuza ma enzyme omwe amagwiritsidwa ntchito limodzi zimawonjezera chiopsezo cha angioedema.
Galvus yokhala ndi zizindikiro zotere siyimaletseka, chifukwa edema imadutsa yokha.
Mankhwalawa sasintha kuchuluka kwa kagayidwe kachakudya pogwiritsa ntchito ma enzymes CYP3A4, CYP1A2, CYP2C8, CYP3A5, CYP2C9, CYP2C19, CYP2D6, CYP2E1.
Malamulo osungira
Pamaukonde a mankhwala, Galvus amagulitsidwa ndi mankhwala. Amatha kusiyanitsidwa ndi chopondera komanso ngati mbali ziwiri: zilembo FB ndi NVR. Pa mbale akhoza kukhala mapiritsi 7 kapena 14 a 50 mg. Mu makatoni okhala ndi matuza kuyambira awiri mpaka khumi ndi awiri.
Mankhwalawa amasungidwa mu kutentha mpaka 30 ° C m'malo opanda kanthu, popanda ana. Moyo wa alumali wa Galvus uli ndi zaka zitatu. Mapiritsi omwe adatha ntchito ayenera kutayidwa.
Ndemanga za madotolo ndi odwala
Wothandizira pakamwa wa hypoglycemic nthawi zambiri amaperekedwa woyamba kwa odwala matenda ashuga akangomupeza. Chifukwa chake, mu ndemanga pamabungwe amawu pamakhala mafunso ambiri kwa endocrinologist kuposa mayankho.
Pothirira ndemanga zotere, madokotala amati matenda ashuga ndi matenda amoyo wonse. Ngakhale Galvus, kapena wina aliyense wothandizila wodwala sangathe kukonza mita ya shuga pa mulingo woyenera kwamuyaya. Umoyo wa munthu wodwala matenda ashuga nthawi zonse akuipiraipira, kusinthaku kwamphamvu kumadalira molingana ndi kuchuluka kwa chiphuphu cha matenda ashuga. Palibe piritsi yodabwitsa kwa odwala matenda ashuga. Kuwongolera kokha zakudya, kukonzanso kwa moyo wonse wokhala ndi mankhwala othandizira kungachepetse kukula kwa zovuta komanso kukhalabe ndi moyo wabwino ndi shuga pamlingo wabwinobwino.
Osati onse opuma pantchito omwe angathe kupita ku Galvus pamtengo wa ma ruble 800. kwa ma pcs 28., ambiri akumufunafuna m'malo mwake, ngakhale Januvia (1400 rubles) kapena Onglisa (1700 rubles) nawonso sagwirizana ndi aliyense. Ndipo omwe akupitilizabe kugwiritsa ntchito amazindikira kuti pang'onopang'ono shuga amayamba kutuluka ndikuyenda bwino kwa mankhwalawa kumachepa.
