Hypoglycemic mankhwala Invokana - zotsatira za thupi, malangizo, kugwiritsa ntchito

Attokana ndi dzina lamalonda lamankhwala lotengedwa kuti muchepetse magazi.

Chidacho chapangidwira odwala omwe ali ndi matenda a shuga a mtundu II. Mankhwalawa amagwira ntchito mothandizidwa ndi monotherapy, komanso limodzi ndi njira zina zochizira matenda ashuga.

Zambiri, kapangidwe ndi mawonekedwe ake amasulidwe

Invocana ndi mankhwala okhala ndi vuto la hypoglycemic. Chochita chake chimapangidwira pakamwa. Invokana wagwiritsidwa ntchito bwino odwala omwe ali ndi matenda a shuga a mtundu II.

Mankhwalawa amakhala ndi moyo wazaka ziwiri zazitali. Sungani mankhwalawo pamtunda osapitirira 30⁰C.

Wopanga mankhwalawa ndi Janssen-Ortho, kampani yomwe ili ku Puerto Rico. Kulongedza kumapangidwa ndi kampani ya Janssen-Silag yomwe ili ku Italy. Wogwirizira ufulu wa mankhwalawa ndi Johnson & Johnson.

Gawo lalikulu la mankhwalawa ndi Kanagliflozin hemihydrate. Piritsi limodzi la Invokana, pali 306 mg yogwira ntchito.

Kuphatikiza apo, 18 mg ya hyprolose ndi anactrous lactose (pafupifupi 117.78 mg) amapezeka pakuphatikizidwa kwa mapiritsi amankhwala. Mkati mwa piritsi mulinso magnesium stearate (4.44 mg), microcrystalline cellulose (117.78 mg) ndi croscarmellose sodium (pafupifupi 36 mg).

Chigoba cha malonda chimakhala ndi filimu, yomwe ili ndi:

• macrogol;
• talc;
• mowa wa polyvinyl;
• titanium dioxide.

Attokana akupezeka mu mawonekedwe a mapiritsi a 100 ndi 300 mg. Pamapiritsi a 300 mg, chipolopolo chomwe chimakhala ndi mtundu woyera chimapezeka; pamapiritsi a 100 mg, chipolopolo chimakhala chikaso. Pamitundu yonse iwiri ya mapiritsi, mbali imodzi pali zolemba "CFZ", ndipo kumbuyo kuli manambala 100 kapena 300 kutengera kulemera kwa piritsi.

Mankhwalawa amapezeka mwa matuza. Chithuza chimodzi chimakhala ndi mapiritsi 10. Paketi imodzi imatha kukhala ndi matuza 1, 3, 9, 10.

Zotsatira za pharmacological

Kanagliflozin monga gawo lalikulu la mankhwalawa amachepetsa reabsorption (reabsorption) shuga. Chifukwa cha izi, kutulutsa kwake ndi impso kumawonjezeka.

Chifukwa cha kubwezeretsanso, kuchepa kwamphamvu kwa kuchuluka kwa shuga m'magazi a wodwalayo kumachitika. Ndi kusiyanitsa kwa shuga, kudzikongoletsa kumachitika. Chifukwa cha izi, magazi a systolic amachepetsa.

Kanagliflozin imapangitsa kuchepa kwa calorie. Invokana amatha kugwiritsidwa ntchito ngati mankhwala ochepetsa thupi. Pa mlingo wa 300 mg, zimathandizira kuchepetsa kuchuluka kwa shuga m'magazi kuposa mlingo wa 100 mg. Kugwiritsa ntchito kwa Kanagliflozin sikupangitsa kuti shuga ayambe kudwala.

Mankhwalawa amathandizira kuchepetsa kufalikira kwa impso. Mukamamwa mankhwalawa, shuga wa impso zimapangidwa bwino. Kwa nthawi yayitali ya Invokana, kuchepa kwamphamvu kwa glucose m'magazi kumadziwika.

Kusala kudya kumathandiza kuchedwa kuyamwa kwa matumbo m'matumbo. M'maphunziro, zidapezeka kuti kuchuluka kwa shuga m'magazi mukamamwa mankhwalawa musanadye komanso mutatha kudya. Kusala kudya kwa glycemia mutadya 100 mg ya mankhwalawa adasinthira kukhala -1.9 mmol / L, ndipo mutatenga 300 mg mpaka 2,4 mmol / L.

Pambuyo pa maola 2 mutatha kudya, kuchuluka kwa shuga m'magazi kunasintha kuchokera ku -2.7 mmol / L pamene kudya 100 mg ndikuchokera -3,5 mmol / L mukamwa 300 mg ya mankhwalawa.

Kugwiritsa ntchito kwa Kanagliflozin kumapangitsa ntchito ya β-cell.

Pharmacokinetics

Kanagliflozin imadziwika ndi kuyamwa mwachangu. Ma pharmacokinetics a chinthu samakhala ndi kusiyana akamatengedwa ndi munthu wathanzi, kapena akatengedwa ndi munthu wodwala matenda ashuga amtundu II.

Mlingo wapamwamba kwambiri wa Kanagliflosin amadziwika pambuyo pa ola limodzi atatenga Invokana. Hafu ya moyo wa mankhwalawa ndi maola 10.6 mukamagwiritsa ntchito 100 mg ya mankhwalawa ndi maola 13.1 mukamamwa 300 mg ya mankhwalawa.

The bioavailability wa mankhwalawa 65%. Itha kuledzeretsa musanadye komanso mutamaliza kudya, koma chifukwa cha zabwino zake, mumalimbikitsidwa kumwa mankhwala musanadye kaye.

Kanagliflozin imagawidwa mokwanira mu minofu. Thupi limalumikizidwa bwino ndi mapuloteni amwazi. Mtengo wake ndi 99%. Katunduyu amagwira ntchito makamaka pakumangirira kwa albin.

Kanagliflosin ali ndi yotsika kuyeretsa kwa zimakhala za thupi. Kuyeretsa impso kuchokera ku chinthu (chimpso) ndi 1.55 ml / min. Nthawi zonse kuyeretsa thupi kuchokera ku Kanagliflozin ndi 192 ml / min.

Zizindikiro ndi contraindication

Mankhwalawa amalembedwa kwa odwala omwe ali ndi matenda a shuga a mtundu II.

Mankhwalawa angagwiritsidwe ntchito:

• ngati njira yodziyimira payokha komanso yochizira matendawa;
• kuphatikiza ndimankhwala ena ochepetsa shuga ndi insulin.

Pakati pazitsutso zomwe zingagwiritsidwe ntchito, oimira akuwonekera:

• kulephera kwambiri kwaimpso;
• tsankho lanu Kanagliflozin ndi zina mwa mankhwala;
• lactose tsankho;
• zaka mpaka 18;
• kulephera kwambiri kwa chiwindi;
• mtundu I shuga;
• kulephera kwa mtima (makalasi atatu ogwira ntchito);
• kuyamwitsa;
• matenda ashuga ketoacidosis;
• mimba

Malangizo ogwiritsira ntchito

Masana, piritsi limodzi la mankhwalawa (100 kapena 300 mg) limaloledwa. Ndikulimbikitsidwa kumwa mankhwalawa m'mawa komanso pamimba yopanda kanthu.

Mukamagwiritsa ntchito mankhwalawa limodzi ndi ena othandizira ndi ma insulin, tikulimbikitsidwa kuti muchepetse mulingo wotsatira kuti mupewe kuchitika kwa hypoglycemia.

Popeza canagliflozin ali ndi diuretic yambiri, kuchuluka kwa mankhwalawa kwa odwala omwe ali ndi vuto laimpso, komanso anthu azaka zopitilira 75, ayenera kukhala 100 mg kamodzi.

Odwala omwe amatha kulolera canagliflozin amalimbikitsa kumwa 300 mg kamodzi patsiku.

Kudumpha mankhwalawa ndikosayenera. Izi zikachitika, muyenera kumwa mankhwalawo nthawi yomweyo. Saloledwa kugwiritsa ntchito mankhwala kawiri patsiku.

Odwala Apadera ndi Mayendedwe

Attokana amapangika mu amayi apakati komanso ana osakwana zaka 18. Mankhwalawa sayenera kumwedwa ndi akazi akumiyendo, popeza Kanagliflozin amalowa mkaka wa m'mawere ndipo amatha kusokoneza thanzi la wakhanda.

Amagwiritsidwa ntchito mosamala ndi anthu opitilira zaka 75. Mankhwala ndi omwe amapereka mankhwala ochepera.

Iwo ali osavomerezeka kuti apereke mankhwala kwa odwala:

• ndi kuwonongeka kwa impso zamphamvu kwambiri;
• aakulu kulephera aimpso otsiriza gawo;
• ikuyimba.

Mankhwalawa amatengedwa mosamala kwa anthu omwe ali ndi vuto lochepa laimpso. Pankhaniyi, mankhwalawa amatengedwa muyezo wochepa - 100 mg kamodzi patsiku. Ndi kulephera kwakakhazikika kwa impso, mulingo wochepa wa mankhwalawo umaperekedwanso.

Ndi koletsedwa kumwa mankhwalawa odwala omwe ali ndi matenda ashuga a 1 mellitus ndi matenda ashuga a ketoacidosis. Kufunika kwa achire chifukwa chomwa mankhwalawa pomaliza chifukwa cha matenda aimpso sikuwoneka.

Attokana alibe machitidwe owononga thupi komanso osokoneza bongo m'thupi la wodwalayo. Palibe chidziwitso cha momwe mankhwalawa amathandizira pakubala kwa munthu.

Mankhwala ophatikizidwa pamodzi ndi mankhwala ndi othandizira ena a hypoglycemic, tikulimbikitsidwa kuti muchepetse mulingo wotsatira kuti mupewe hypoglycemia.

Kuchepa kwa kuchuluka kwa intravascular nthawi zambiri kumachitika mwezi woyamba ndi theka kuyambira chiyambi cha mankhwala ndi Invocana.

Kuletsa kwa mankhwalawa kumafunika chifukwa cha zomwe zimachitika mwadzidzidzi:

• vulvovaginal candidiasis mwa akazi;
• candida balanitis mwa amuna.

Kuposa 2% ya azimayi ndi 0,9% ya amuna anali ndi matenda obwerezabwereza akamamwa mankhwalawa. Milandu yambiri ya vulvovaginitis imawonekera mwa amayi mkati mwa masabata 16 oyamba kuchokera pomwe anayamba chithandizo ndi Invocana.

Pali umboni wazomwe zimapangitsa mankhwalawo kuphatikizika kwa mafupa mwa anthu omwe ali ndi matenda amtima. Mankhwalawa amatha kuchepetsa mphamvu yam'mafupa, zomwe zimapangitsa kuti akhale pachiwopsezo cha kuwonongeka pagulu la odwala. Mankhwala osamala amafunika.

Chifukwa cha chiwopsezo chachikulu chotenga hypoglycemia ndi chithandizo chophatikizira cha Invokana ndi insulin, tikulimbikitsidwa kupewa kuyendetsa.

Zotsatira zoyipa ndi bongo

Zina mwazotsatira zoyipa za kumwa mankhwalawa ndi:

• kumverera kwa ludzu;
• kutsika kwa intravascular voliyumu mu mawonekedwe a chizungulire, kuchepa magazi, kutsitsa magazi, kukomoka;
• vulvovaginal candidiasis mwa akazi;
• kudzimbidwa;
• polyuria;
• nseru
• urticaria;
• kamwa yowuma
• balanitis, balanoposthitis mwa amuna;
• cystitis, matenda a impso;
• hypoglycemia mogwirizana ndi insulin;
• kuchuluka kwa hemoglobin;
• kuchepetsa uric acid wambiri;
• matenda ashuga ketoacidosis;
• kuchepa kwa mafupa;
• kuchuluka kwa seramu potaziyamu;
• kuchuluka kwa mafuta m'thupi m'magazi.

Nthawi zina, kumwa mankhwalawa kunadzetsa kulephera kwa impso, anaphylactic mantha, ndi angioedema.

Palibe milandu ya bongo ndi mankhwalawa. Mlingo wa 1600 mg unalekeredwa bwino ndi anthu athanzi komanso mlingo wa 600 mg patsiku kwa anthu omwe ali ndi matenda a shuga a 2.

Pakakhala vuto la bongo, m'mimba mumachitika, ndipo wodwalayo amayang'aniridwa. Kutsegula vuto la bongo kumatha.

Kuchita ndi mankhwala ena ndi analogi

Yogwira pophika mankhwala mosavuta atengere a oxidative kagayidwe. Pazifukwa izi, mphamvu ya mankhwala ena pazomwe zimachitika canagliflozin ndizochepa.

Mankhwala amalumikizana ndi mankhwala otsatirawa:

• Phenobarbital, Rifampicin, Ritonavir - kuchepa kwa mphamvu ya Attokana, kuchuluka kwa mankhwalawa ndikofunikira;
• Probenecid - kusowa kwakukulu kwa zotsatira zamankhwala;
• Cyclosporin - kusowa kwakukulu kwa mankhwala;
• Metformin, Warfarin, Paracetamol - panalibe zofunika kwambiri pa pharmacokinetics ya canagliflozin;
• Digoxin ndimayanjano ocheperako omwe amafunika kuwunika momwe wodwalayo alili.

Mankhwala otsatirawa ali ndi vuto lofanana ndi a Attokana:

• Glucobay;
• NovoNorm;
• Jardins;
• Glibomet;
• Piroglar;
• Guarem;
• Victoza;
• Glucophage;
• Methamine;
• Fomu;
• Glibenclamide;
• Glurenorm;
• Glidiab;
• Glykinorm;
• Yodzala;
• Trazenta;
• Galvus;
• Glutazone

Malingaliro odwala

Kuchokera pa ndemanga za anthu odwala matenda ashuga okhudzana ndi Singokan, titha kunena kuti mankhwalawa amachepetsa shuga m'magazi komanso zotsatira zoyipa ndizosowa kwenikweni, koma pamakhala mtengo wokwanira wa mankhwala omwe amakakamiza ambiri kuti asinthane ndi mankhwala a analog.

Dokotala wanga yemwe adakhalapo adandiuza kuti azindiyimira chifukwa ndili ndi matenda ashuga a 2. Mankhwala othandiza. Zotsatira zoyipa zochepa. Sindinawonepo zochitika zilizonse panthawi yonse ya chithandizo. Mwa mphindi, ndikufuna kudziwa mtengo wake.

Tatyana, wazaka 52

Dotolo adalimbikitsa mankhwalawa a shuga a Attokan. Chipangizocho chikuwoneka chothandiza. Kutsika kosalekeza kwa shuga m'magazi kunadziwika. Panali zotsatirapo zoyipa ngati mkanda waung'ono, koma mutasintha mankhwalawo, zonse zinapita. Zoyipa zake ndiye mtengo wokwera kwambiri. Pali mitundu yambiri yofananira.

Alexandra, zaka 63

Ndakhala ndikudwala matenda a shuga kwa nthawi yayitali ndipo ndidaganiza zosinthira ku Invocana. Chida chokongola kwambiri, sikuti aliyense angakwanitse. Pakukonzekera osati koyipa. Ndimakondwera ndi zochepa zotsutsana ndi zotsatira zoyipa poyerekeza ndi mankhwala ena a shuga.

Oleg, zaka 48

Zojambula pazakanema, mitundu ndi chithandizo cha matenda ashuga:

Mtengo wa mankhwalawa m'mafakitala umachokera ku 2000-4900 rubles. Mtengo wa analogies ya mankhwalawa ndi ma rubles a 50-4000.

Chogawikacho chimaperekedwa pokhapokha ngati amupatsa katswiri wochiritsa.