Limagwirira a zochita za saxagliptin pa thupi shuga

Kukula kwa matenda ashuga amtundu wa 2 padziko lapansi ukukula, izi zikuchitika chifukwa cha chikhalidwe cha anthu komanso chakudya chamagulu ambiri. Komabe, pharmacology siyimayima, ndikupanga zinthu zatsopano zochizira matenda ashuga.

Limodzi mwamagulu atsopano a zinthu zoterezi ndi ma incretin mimetics, omwe amaphatikizapo saxagliptin (saxagliptin).

Limagwirira a zochita za ma impretins

Ma insretins ndi mahomoni amunthu omwe amapangidwa ndi m'mimba thirakiti chakudya chikamalowa. Chifukwa cha zomwe amachita, kupanga insulini kumachulukana, komwe kumathandiza kuti glucose ayamwidwe, omwe amamasulidwa pakudya.

Mpaka pano, mitundu iwiri ya ma insretins yapezeka:

• GLP-1 (glucone-peptide-1);
• ISU (insulinotropic polypeptide).

Ma receptor oyamba ali m'magulu osiyanasiyana, zomwe zimamupatsa mwayi wowonetsa bwino. Yachiwiri imayendetsedwa ndi ma pancreatic β-cell receptors.

Mwa zina mwazofunikira zochita:

• kuchuluka katulutsidwe wa insulin ya mahomoni ndi maselo a pancreatic;
• Kuchepetsa m'matumbo;
• kuchepa kwa shuga;
• kusachepa kwa chakudya ndi kumva kuti mwakhuta;
• kusintha kwa mtima ndi mitsempha yamagazi, zimathandiza mu ubongo.

Pakuwonjezereka kwa kupanga kwa insulini, shuga amaphatikizidwa bwino, koma ngati zili zabwinobwino, njira yobisalira imasiya ndipo munthuyo sakhala pachiwopsezo cha hypoglycemia. Kutsika kwa kuchuluka kwa glucagon, wotsutsana ndi insulin, kumabweretsa kuchepa kwa kudya kwa chiwindi glycogen ndi kumasulidwa kwa shuga wamagazi, pomwe munthawi yomweyo kumathandizira kuwonjezeka kwa kumwa kwa glycogen m'misempha. Zotsatira zake, shuga imagwiritsidwa ntchito nthawi yomweyo pamalo opangira, osalowa m'magazi.

Kutulutsa kwam'mimba kuchepa, chakudya chimalowa m'matumbo m'magawo ang'onoang'ono, omwe amachepetsa kuchuluka kwa glucose m'magazi ndipo, chifukwa chake, kuchuluka kwake. Kuchita zinthu zing'onozing'ono, kumalowa mosavuta m'thupi. Potere, kuchepa kwa chakudya kumachepetsa kudya kwambiri.

Zokhudza momwe magazi amayendera tsopano zangodziwika, koma osaphunzira. Zapezeka kuti ma insretins amathandiza pancreatic β-cell kuchira mofulumira.

Ndizosatheka kupeza mahomoni mu mawonekedwe awo oyera mokwanira, chifukwa chake asayansi apanga ma analogu omwe amagwira ntchito zofanana:

• kukonzanso mphamvu ya glucone-peptide-1;
• Kuchepetsa mphamvu za ma enzyme owononga, motero kukulitsa moyo wa mahomoni.

Saxagliptin ndi wa gulu lachiwiri.

Kutulutsa Mafomu

Saxagliptin ndi gawo limodzi la mankhwala Onglisa, amagwira ngati choletsa DPP-4. Chida ichi sichiri pamndandanda wabungwe la chithandizo chamankhwala, koma chingaperekedwe kwa odwala omwe ali ndi matenda osokoneza bongo pakulipiritsa ndalama zakomweko.

Mankhwalawa amapezeka mwa mapiritsi okhala ndi chipolopolo chachikasu, chokhala ndi 2.5 mg ya saxagliptin kapena 5 mg ya hydrochloride yake. Kuphatikizikako kumaphatikizanso magawo omwe amakhathamiritsa mphamvu ya ntchito. Mapiritsiwa alembedwa kuti awonetsetse ake.

Mapiritsi amadzaza paketi yonyamula zidutswa 10 ndi kabokosi.

Zizindikiro ndi contraindication

Kukonzekera kochokera ku Saxagliptin ndikulimbikitsidwa kuti mugwiritse ntchito ndi:

1. Gawo lokhala ndi matenda ashuga, pamene miyambo, kuphatikizapo zakudya, masewera olimbitsa thupi ndi malingaliro ena sizithandiza. Chidacho chimakupatsani mwayi wokuletsa kuwonongedwa kwa maselo a β-ndipo poteteza zolengedwa zamitundu iwiri;
2. Kukhalapo kwa matenda opezeka. Potere, chida chitha kugwiritsidwa ntchito ngati mankhwala odziyimira pawokha kaphatikizidwe ndi mankhwala ena:
   • Metformin;
   • insulin;
   • zotumphukira sulfonylurea;
   • kachikachiyama.

Zotsatira zoyenera kumwa mankhwalawa ndi:

• mtundu 1 matenda a shuga;
• kutengeka kwambiri pazinthu zilizonse za mankhwala;
• chidwi chachikulu ndi ma DPP-4 zoletsa;
• kukhalapo kwa matenda ashuga ketoacidosis;
• indigestibility ya lactose ndi kuchepa kwa lactase, kobadwa nako shuga-galactose malabsorption;
• nthawi ya bere ndi mkaka oyamwa;
• zaka zazing'ono.

Milandu iyi, ma fanizo a mankhwalawa amagwiritsidwa ntchito kapena ndalama zomwe zimapangidwa mosiyanasiyana zimasankhidwa.

Kugwiritsa ntchito poyambira mankhwala saxagliptin + metformin

Malangizo ogwiritsira ntchito

Mapiritsi amatengedwa pakamwa mosaganizira zakudya. Kapholo kam'meza lonse ndikusambitsidwa ndi madzi pang'ono. Mlingo umatengera mtundu wa chithandizo komanso thanzi la wodwalayo.

Pogwiritsa ntchito mosiyanasiyana, saxagliptin tikulimbikitsidwa kutenga 5 mg kamodzi patsiku.

Kuphatikiza pamankhwala ena odwala matenda ashuga, mlingo ndi 5 mg patsiku, zomwezo zimagwiritsidwa ntchito pophatikiza omwe amagwiritsidwa ntchito kale ndi othandizira a hypoglycemic ndi saxagliptin.

Pakumayambiriro kogwiritsa ntchito chinthucho ndi metformin, mulingo wa saxagliptin ndi mamiligalamu asanu, ndipo metformin ndi 500 milligrams patsiku.

Kwa odwala omwe ali ndi matenda a impso, mlingo umachepetsedwa kukhala 2.5 mg patsiku. Ngati hemodialysis imagwiritsidwa ntchito, mankhwalawa amamwa atamaliza. Zotsatira za mankhwalawa pa peritoneal dialysis sizinafufuzidwe. Mulimonsemo, asanalembe mankhwala, akatswiri amalangizidwa kuti ayesetse impso za wodwalayo.

Kwa odwala omwe ali ndi vuto la chiwindi ntchito, kusintha kwa mankhwalawa sikofunikira. Kuchiza kumachitika malinga ndi malingaliro onse. Izi zikugwiranso ntchito kwa okalamba, ngati alibe mavuto a impso.

Kafukufuku wokhudzana ndi mphamvu ya mankhwalawa mwana wosabadwa m'mimba mwa amayi apakati ndi ana aang'ono sanachitike. Chifukwa chake, ndizovuta kulosera zamtsogolo. Kwa odwala awa, othandizira ena omwe amagwiritsidwa ntchito nthawi zambiri amagwiritsidwa ntchito. Ngati mayi amatenga saxacgliptin pa nthawi yoyamwitsa, ayenera kukana kudyetsa.

Pankhani ya munthawi yomweyo makonzedwe othandizira a CYP3A4 / 5, mlingo wa tsiku lililonse wa mankhwalawa umachepa.

Awa ndi mankhwala awa:

• Ketoconazole;
• Clarithromycin;
• Atazanavir;
• Indinavir;
• Nefazodon;
• Itraconazole;
• Ritonavir;
• Telithromycin;
• Nelfinavir;
• Saquinavir ndi ena.

Mukumwa mankhwala a saxagliptin, wodwalayo amapitiliza kukhazikitsa malangizo a gulu la chakudya, amalimbitsa thupi ndikuwunika momwe munthu akumvera.

Zotsatira zoyipa ndi bongo

Mankhwalawa alibe zotsatira zoyipa. Ubwino wake waukulu ndikusowa kwa chiopsezo cha hypoglycemia.

Komabe, monga mankhwala aliwonse opangira, zimakhudza kayendedwe kazinthu zathupi, zimathandizira pakusintha kwawo, zomwe zingayambitse:

• chitukuko cha matenda opatsirana a kupuma;
• mavuto a dyspeptic;
• sinusitis
• mawonekedwe a mutu;
• gastroenteritis;
• kukula kwa kutupa kwamkati mwa genitourinary system.

Mukawona zina mwazizindikirozi, muyenera kudandaula kwa asing'anga omwe angasankhe kuchuluka kwa mankhwalawo kapena kuisintha pamapiritsi ena.

Mankhwala osokoneza bongo m'mayesero azachipatala sanawonekere, pomwe zozama za 80 pompopompo kuposa zomwe adalimbikitsa zidagwiritsidwa ntchito. Pankhani ya zizindikiro za bongo (nseru, kusanza, kutsegula m'mimba, kupweteka kwa mutu, kufooka, ndi zina), mankhwalawa amachitika molingana ndi zizindikirazo ndikuchotsedwa kwachangu kwa mankhwala mthupi, zomwe ndizosavuta kudzera mwa hemodialysis.

Akaphatikizidwa ndi mankhwala ena, zopatukazo sizinapezeke. Komabe, kugwiritsa ntchito limodzi ndi metformin ndi thiazolidinediones sikunaphunzire.

Kanema kuchokera kwa katswiri:

Chingalowe m'malo ndi saxagliptin ndi chiyani?

Kugwiritsa ntchito saxagliptin monga gawo lalikulu limapangidwa mu mankhwala a Onglise, ngati wodwalayo ali ndi zovuta, ayenera kugwiritsa ntchito analogues, yomwe imaphatikizanso zoletsa zina za envime ya DPP-4:

1. Januvia - Chimodzi mwa zida zoyambirira zamtunduwu, zopangidwa ku United States. Imazindikira mu Mlingo wa 25, 50 ndi 100 mg. Zomwe zimachitika tsiku lililonse zimakhala pafupifupi 100 mg. Zotsatira za mankhwalawa zimatha pafupifupi tsiku limodzi. Nthawi zina amapangidwa pansi pa mtundu wa YanuMet, womwe umaphatikizanso ndi metformin.
2. Galvus - mankhwala omwe amapangidwa ku Switzerland, amagwiritsidwa ntchito pa mlingo wa 50 mg tsiku lililonse kapena kupitilira apo, amagwiritsidwa ntchito limodzi ndi insulin.
3. Nesina - wopangidwa ku Ireland, kutengera apolgiptin benzoate ndi mlingo wa 12,5 kapena 25 mg. Piritsi limodzi amatengedwa kamodzi patsiku.
4. Vipidia - chinthu chachikulu cha mankhwala a alogliptin, omwe ali ndi vuto lofananalo, amatengedwa kamodzi patsiku pa mlingo wa 25 mg.
5. Trazhenta - chida chochokera linagliptin, chimadziwika ngati mapiritsi 5 mg omwe amamwa pakamwa.

Ma analogu ena amagwiritsidwa ntchito omwe ali ndi mawonekedwe osiyana, koma mawonekedwe ofanana. Mtengo wa mankhwalawa umasiyanasiyana malinga ndi dziko lomwe akupanga komanso kapangidwe ka mankhwalawo.

Mtengo wa mankhwalawa Onglisa, wophatikiza saxagliptin, kuyambira 1700 mpaka 1900 rubles.

Mbadwo watsopano wamankhwala umapangitsa kuti zitheke mwachangu komanso mosavuta mavuto amtundu wa glucose omwe ali ndi odwala omwe ali ndi matenda osokoneza bongo.

Pomwe mndandanda wawo sunali waukulu kwambiri, ndi mankhwala amodzi okha omwe amapangidwa pamaziko a saxagliptin, omwe ali ndi zotsatira zabwino pothandizira matenda a shuga ndipo samayambitsa matenda a hypoglycemia. Nthawi yomweyo, pali ma fanizo omwe ali ndi chinthu china chosiyana, koma ndimankhwala ofanana.