Baeta ndi hypoglycemic wothandizira kupangira shuga m'magazi a 2 shuga. Exenatide imatchulidwa kuti amino acid amidopeptides. Monga incretin mimetic, imachepetsa chimbudzi, imakulitsa ntchito yama b-cell. Kuchokera ku insulin yachikhalidwe, mankhwalawa amasiyanitsidwa ndi kuthekera kwa pharmacological ndi mtengo wake.
Ndani akuwonetsedwa exenatide
Mankhwalawa amalembedwa kwa odwala matenda ashuga amtundu wachiwiri wa matenda (kupatula ana ndi amayi apakati). Ngati chithandizo cha Metformin ndi mankhwala ena a hypoglycemic sichimapereka zotsatira zomwe zikufunikira, Bayete imayikidwa ngati mankhwala owonjezera. Jakisoni amagwiritsidwanso ntchito ngati monotherapy. Chofunika kwambiri pamankhwala osokoneza bongo omwe amadalira insulin ndi kuthekera kwa mankhwalawa kuti athe kulola chilakolako cha thupi ndi kunenepa kwambiri.
Kutulutsa Fomu
Baeta ndi yankho popanda mtundu ndi fungo. 1 ml ya yogwira gawo la exetanide ili ndi 250 mcg. Udindo wazowonjezera zosakaniza ndi acetic acid, sodium acetate trihydrate, matacresol, mannitol ndi zina zotulutsa.
Mankhwalawa amamasulidwa mu cholembera chimodzi - analogue ya m'badwo watsopano wa insulin. Kuchuluka kwa mankhwala mu cholembera chotere ndi 1.2 kapena 2.4 ml (phukusi lirilonse - syringe imodzi).
Kwa mankhwala a Bayet, Exenatide yokha ndi yomwe ingakhale ngati analogue.
Kuthekera kwa Pharmacodynamic
Kodi chimachitika ndi chiyani ku Bayeta pambuyo pa kayendetsedwe ka ma subcutaneous? Magwiridwe ochita mankhwalawa ndi osavuta. Ma insretins, omwe akuimira omwe ali exenatide (wogwira ntchito popanga mankhwala), amathandizira kupanga insulin ndikupangitsa kuti shuga asapangidwe ndi chiwindi.
Exenatide Baeta imathandizira odwala matenda ashuga kuthana ndi shuga motere:
- Ndi mfundo zazikulu za glucometer, mankhwalawa amachititsa kuti insulin parenchyma ipangidwe.
- Thupi la shuga litangoyandikira bwino, katulutsidwe ka timadzi tokha timayima.
- Pankhani ya shuga osadalira insulini, Baeta atangophika, kupanga insulin sikuwonekera kwa mphindi 10 zoyambirira. Mankhwalawa amabwezeretsa kuyankha kwa insulin m'magawo onse awiri.
Imachepetsa kugaya chakudya, imachepetsa chilakolako chofuna kudya komanso matumbo (mpaka kudzimbidwa).
Zolemba za Pharmacokinetic
Kodi mankhwala amamwa bwanji, amagawidwa, amamwa bwanji?
- Pambuyo jakisoni, chigawo chogwira ntchito (exenatide) chimafalikira mwachangu kudzera mu ziwalo zamkati ndikuchita zochizira. Pa mlingo wa 10 μg wa mfundo zamtengo wapatali, umafika patatha maola awiri. Dongosolo la jakisoni (ntchafu, mkono wam'mbuyo kapena pamimba) silikuwawononga mayamwidwe ndikuwoneka bwino.
- Mankhwalawa amaphatikizidwa m'matumbo am'mimba, magazi mthupi ndi kapamba. Mphamvu zake zamankhwala samadalira mlingo.
- Impso zimachotsa Bayetu maola 10. Mu aimpso a impso, kusintha kwa mankhwalawa sikofunikira, popeza chiwonetsero cha mankhwala omwe ali m'gulu ili la odwala ali pafupi kwambiri.
- Popeza mankhwalawa amachotsedwa ndi impso, ma hepatic pathologies sasintha zomwe zili exenatide m'magazi a m'magazi.
Zochitika zokhudzana ndi zaka sizikhudza kayendedwe ka zomwe zimagwira ntchito, chifukwa chake, mukulira, kusintha kwa mankhwala sikofunikira. Mu ubwana (mpaka zaka 12), zotsatira za exenatide sizinaphunzire. Muubwana (zaka 12-18) mwa omwe amalandira mlingo wa 5 μg wa anthu odwala matenda ashuga, zomwe zimachitika anali ofanana ndi akulu.
Amuna ndi akazi amachitanso chimodzimodzi ndi chithandizo cha Bayeta. Panalibe kusiyana pakati pa oimira mafuko osiyanasiyana, zomwe zikutanthauza kuti kusintha kwa mlingo malinga ndi njira zotere sikofunikira pamagulu awa a odwala matenda ashuga.
Baeta panthawi yoyembekezera
Pa nthawi yoyembekezera komanso mkaka wa m`mawere, jakisoni wa Bajeta amatsutsana, chifukwa zinthu zomwe zimagwira zimakhudza kupangidwe kwa mwana wosabadwayo. Makamaka, kugwiritsa ntchito Bajeta kumatha kupangitsa mtundu wa shuga wodwala kukhala ndi insulin.
Kukula, thupi la mwana limagwira ntchito ya insulin synthesis. Kondomu ya mwana wosabadwayo imayang'anira kukhudzika kwa glycemic mwa mwana ndi mayi. Chifukwa chake, pamene mukukonzekera kukhala ndi pakati, muyenera kukayezetsa ndi kupeza upangiri mwatsatanetsatane wa kumwa mankhwala otetezedwa munjira zatsopano.
Contraindication
Maziko a contraindication kuti atenge mankhwala a Bayet ndi chitetezo cha munthu chogwira ntchito pafomula. Mankhwalawa sanatchulidwe odwala matenda ashuga omwe ali ndi mtundu woyamba wa matenda, komanso munthawi ya matenda a shuga a ketoacidosis. Mankhwala siwothandiza kwa odwala omwe ali ndi matenda am'mimba, matumbo, impso, komanso gastroparesis.
Bayeta siziwonetsedwanso kwa ana, popeza kuchuluka kwa mphamvu ndi chitetezo cha mankhwala kwa ana sichinayesedwe. Ndi thupi lawo siligwirizana ndi zosakaniza za metabolite, palibe mankhwala omwe amapatsidwa.
Zotsatira zoyipa
Byeta nthawi zambiri samayambitsa zovuta zosafunikira. Ngati imagwiritsidwa ntchito ngati monotherapy, kuchuluka kwa hypoglycemic syndrome kuli pafupifupi 5% (poyerekeza ndi 1% placebo).
Zambiri mwa milanduzi zimadziwika ndi kuchepa kwambiri. Ngati zikuwoneka, ndiye kuti ndizotheka, ngati malingaliro azachipatala sanatsatidwe, mankhwalawo amatha, kapena ngati asungidwa molakwika.
Ngakhale kawirikawiri, Baeta imapangitsa kukondoweza kwa matenda a impso komanso kuchuluka kwa creatinine. Muzochitika zamankhwala, chidziwitso cha nephrotoxicity cha exenatide sichinalembedwe, kupatula zigawo za munthu zomwe zimapweteka pachimake. Anthu odwala matenda ashuga ayenera kudziwitsidwa zizindikiro za matendawa.
Jekeseni woyamba akhoza kukhala limodzi ndi kufooka, kunjenjemera, nthawi zina - angioedema ndi anaphylactic mantha. Ngati zotsatira zoyipa zadziwika, njira yolandirayo imayimitsidwa ndipo adokotala amafunsira kwa endocrinologist.
Popeza mankhwala onse okhala ndi mapuloteni ndi ma peptides amatha kupangitsa kuti immunogenicity, ma antibodies ophatikizika pophika atha kupangidwa nthawi ya Bayeta mankhwala, gawo lawo limatsika pakapita nthawi ndipo limatsika. Kukhalapo kwa ma antibodies sikumakhudza ma frequency ndi mitundu ya zovuta zoyipa.
Anthu odwala matenda ashuga ayenera kuchenjezedwa kuti jakisoni a Bayeta amathandizira kuti asakhale ndi chidwi chambiri komanso azitha kunenepa. Izi momwe thupi silitengera kukonzedwa kwawamba.
Maupangiri Ogwiritsira Ntchito
Bayetu amagwiritsidwa ntchito ngati monotherapy, kuwonjezera zakudya zama carb otsika komanso minofu minofu, kukulolani kuti mulamulire shuga. Mankhwala ophatikizidwa, majakisowa amaphatikizidwa ndi mapiritsi a Metformin, thiazolidinedione, sulfonylureas, komanso kuphatikiza kwawo kuti akwaniritse bwino kwambiri glycemic control.
Dongosolo la chithandizo likupangidwa ndi dokotala. Mankhwalawa amawadulira pansi pakhungu pamimba, m'chiuno, pamphumi. Pa gawo loyamba la chithandizo, mankhwalawa osachepera 5 mcg amaperekedwa m'mawa ndi madzulo. Mankhwalawa amayenera kumwa pasanathe ola limodzi asanadye. Mukatha kudya, jakisoni sililimbikitsidwa. Pakatha mwezi, ndikazolowera, chizolowezi chimatha kuchulukitsidwa. Ndi kukonzaku, palibe zotsatira zoyipa.
Ngati nthawi ya jakisoni ikusowa, jakisoni wotsatira amachitidwa popanda kusintha mlingo. Sitikulimbikitsidwa kubaya yankho mu mtsempha kapena minofu. Ngati Byeta adagwiritsidwa ntchito popanga mankhwala osokoneza bongo a sulfonylurea, chizolowezi chomaliza chimachepetsedwa kuti muchepetse chiopsezo cha zotsatira zoyipa kapena bongo.
Dokotala ayenera kudziwitsa wodwalayo za malamulo ogwiritsira ntchito cholembera. Kumvetsetsa njirayi kukuthandizani kuti muphunzitse kanema pa kanemayu.
Zizindikiro zosokoneza bongo
Ndi njira yodzilankhulira nokha komanso kuyesera kwa mlingo, mankhwala osokoneza bongo amatha. Mutha kuzindikira mkhalidwewo mwa zizindikiritso: kusowa chilakolako cha chakudya, kusintha kwa zokonda, zovuta zakusokonekera, kusintha kwa mawonekedwe a kuchepa. Mchitidwe wamanjenje umayimira kuledzera ndikupweteka mutu, kusagwirizana, komanso kuwonongeka pakuloza.
Koma nthawi zambiri chizindikirochi chimapezeka pakhungu: totupa, kutupa, kuyamwa pamalo opaka jekeseni. Kukula kwa zizindikirazo ndizocheperako, mankhwalawo ndiwodziwonetsa. Nthawi zambiri, muzochitika zotere, mlingo umatsimikiziridwa ndi Bayeta, pakakhala zovuta zazikulu, mankhwala onse omwe ali ndi zotsatira zofananira amachotsedwa.
Kuphatikiza Zotsatira za Therapy
Mukamasankha mtundu wa mankhwala a Bayeta, endocrinologist ayenera kudziwa za mankhwala onse omwe wodwala matendawa amatenga pakadali pano. Makamaka amapatsidwa chidwi ndi mapiritsi omwe amatengedwa pakamwa ndikuyamwa. Popeza mankhwalawa amachedwa kutayika m'mimba, ndikofunikira kumwa mankhwala ena 2 maola jekeseni asanafike.
Ndi chithandizo chofanana ndi chiwembu "Baeta kuphatikiza Digoxin" mphamvu ya mankhwala yomaliza imachepa. Odwala othamanga omwe amagwiritsa ntchito Lisinopril ayeneranso kupirira nthawi yayitali pakati pa jakisoni ndi mapiritsi. HMG-CoA reductase inhibitors sizisintha kapangidwe wamafuta am'mwazi (otsika komanso okwera kwambiri lipids, triglycerol, cholesterol yathunthu) pa mankhwala ogwirizana.
Kugwiritsa ntchito Baeta kumbuyo kwa insulin mankhwala, komanso kukonzekera kwa D-phenylalanine, meglitinide kapena b-glucosidase inhibitors, sikunaphunzire. Mankhwala ena amatha kupweteketsa mtima akaphatikizidwa ndi Bayeta, ndipo ndi dokotala yekha amene angayang'ane zovuta zonse zomwe amachita.
Zosunga mu syringe pensulo
Kwa Bayeta, malangizo ogwiritsira ntchito amafotokozera mwatsatanetsatane mikhalidwe yonse yosungirako. Kuti mukhale ndi zida zothandizira, muyenera kusankha malo owuma, amdima komanso ozizira omwe ali ndi kutentha kwa madigiri 2-8. Ngati zolimba zidasokonekera ndipo cholembera chake chidayamba kugwira ntchito, ziyenera kusiyidwa ndi kutentha kwa firiji (mpaka madigiri 25).
Moyo wa alumali wa mankhwala oterowo suwapitilira mwezi umodzi. Kufikira kwa ana ku nduna yamankhwala kuyenera kukhala kochepa. Mukasunga ma CD mu firiji, Baete sayenera kuzizira.
Osasiya cholembera ndi singano yomwe imalumikizidwa nthawi yayitali. Pambuyo pa njirayi, singano imachotsedwa, ndipo jekeseni wotsatira, asanayikenso, amaikidwa watsopano. Kunyalanyaza mawonekedwe osungirako a mankhwalawa kumachepetsa kuchiritsa kwake. Ngati yankho lomveka ndilopanda mitambo, ma lunguti amapezeka, mankhwalawo amasintha mtundu, ndipo mankhwalawo ayenera kutayidwa.
Amawamasula mumakina a Bajetu ndi mankhwala. Mankhwalawa ayenera kugwiritsidwa ntchito patatha zaka ziwiri kuchokera chaka chamasulidwe chawonetsedwa pabokosi. Mankhwala omwe atha ntchito sangathe kugwiritsidwa ntchito - kuwonjezera pazoyenda zochepa, chiopsezo chotsatira chazovuta chikuwonjezeka. Ubwino wamankhwala umatanthauzanso kutsatira malamulo osungira.
Baeta: ndemanga pabwaloli
Mabwalo amitu akukambirana mwachangu kuthekera kwa kukonza minofu mothandizidwa ndi Bayeta. Osati odwala matenda ashuga okha omwe anachita chidwi ndi mankhwalawo.
Malangizo apadera
Baeta ndi mankhwala omwe amapangidwa ngati mankhwala opangira glucagon-peptide-1 wa thupi la munthu, koma nthawi yake yowonekera ndiyotalikirapo. Ubwino wake kwa anthu odwala matenda ashuga umagona ndendende chifukwa chakuti umagwira ngati timunthu wa munthu. Kuphatikiza pa kuwongolera kunenepa komanso kuwongolera glycemic, hemoglobin ya glycosylated imakhala bwino ndi 1-1.8%.
Mwa zabwino zake zambiri, poyerekeza ndi njira zina, Baeta ilibe zovuta. Njira yotulutsira mankhwalawa imangotengera ma jakisoni amkati, mapiritsi a analogue sanapangidwe. Theka lachitatu la anthu odwala matenda ashuga omwe akhala akugwiritsa ntchito mankhwalawa kwa nthawi yayitali ali ndi zodandaula za zizindikiro zosakhalitsa za zovuta zoyipa.
Pamene metabolite ikalakwika, gawo la GLP-1 limatha kulumpha nthawi zina, ndipo mwina limakhala ndi hypoglycemia. Baeta monga metabolic othandizira yadzitsimikizira yokha mu chithandizo chovuta ndi mankhwala ena a hypoglycemic.
Kanemayo akuwonetsa malangizo a pang'onopang'ono ogwiritsira ntchito zolembera zatsopano za syringe.
