Type 2 shuga mellitus ndi matenda a metabolic omwe amapezeka chifukwa cha kuyanjana kwa insulin ndi maselo.
Anthu omwe ali ndi mtundu uwu wa malaise sangakhalebe ndi shuga wokwanira kudzera mu zakudya komanso njira zina zapadera. Madokotala amamulembera Vildagliptin, amene amachepetsa ndikuwonjezera shuga m'milingo yoyenera.
Zambiri, kapangidwe ndi mawonekedwe ake amasulidwe
Vildagliptin ndi nthumwi ya gulu latsopano la mankhwalawa omwe amagwiritsidwa ntchito mosamala pochiza matenda amtundu wa 2. Imalimbikitsa ma pancreatic islets ndipo imalepheretsa ntchito ya dipeptidyl peptidase-4. Ili ndi vuto la hypoglycemic.
Mankhwalawa atha kutumikiridwa ngati chithandizo chachikulu, komanso kuphatikiza ndi mankhwala ena. Zimaphatikizidwa ndi zotumphukira za sulfonylurea, ndi thiazolidinedione, ndi metformin ndi insulin.
Vildagliptin ndi dzina lapadziko lonse lapansi pazomwe zimagwira. Mankhwala awiri okhala ndi izi amaperekedwa pamsika wamankhwala, mayina awo ogulitsa ndi Vildagliptin ndi Galvus. Loyamba limangokhala ndi Vildagliptin, lachiwiri - kuphatikiza kwa Vildagliptin ndi Metformin.
Kutulutsa mawonekedwe: mapiritsi okhala ndi mlingo wa 50 mg, atanyamula - 28 zidutswa.
Pharmacodynamics ndi pharmacokinetics
Vildagliptin ndi chinthu chomwe chimalepheretsa dipeptidyl peptidase ndi kuwonjezeka momveka bwino mu GLP ndi HIP. Mahomoni amatulutsidwa m'matumbo mkati mwa maola 24 ndikuchulukitsa poyankha pakudya. Thupi limalimbikitsa kuzindikira kwa maselo a betta a shuga. Izi zimapangitsa kuti magwiritsidwe ntchito a glucose amadalira secretion wa insulin.
Ndi kuwonjezeka kwa GLP, pali kuwonjezeka kwa kulingalira kwa maselo a alpha kuti akhale shuga, omwe amatsimikizira kuti matenda a shuga amatengera shuga. Pali kuchepa kwa kuchuluka kwa lipids m'magazi pochiritsira. Ndi kuchepa kwa glucagon, kuchepa kwa insulin kukaniza kumachitika.
Zomwe zimagwira zimagwira mwachangu, zimachulukitsa mahomoni m'magazi pambuyo pa maola 2. Kumanga mapuloteni ochepa kumadziwika - osaposa 10%. Vildagliptin imagawidwa chimodzimodzi pakati pa maselo ofiira am'magazi ndi madzi a m'magazi. Kuchuluka kwake kumachitika pambuyo pa maola 6. Mankhwalawa amatengeka bwino pamimba yopanda kanthu, pamodzi ndi chakudya, mayamwidwe amachepa pang'ono - - 19%.
Sichichita ndipo sichichedwetsa isoenzymes, si gawo lapansi. Imapezeka m'madzi a m'magazi pambuyo pa maola 2. Hafu ya moyo kuchokera ku thupi ndi maola atatu, ngakhale mutamwa. Biotransfform ndiye njira yayikulu yodziwitsira kunja. 15% ya mankhwalawa amachotsera ndowe, 85% - ndi impso (zosasinthika 22.9%). Kuphatikizika kwakukulu kwa zinthu kumatheka pokhapokha mphindi 120.
Zizindikiro ndi contraindication
Chizindikiro chachikulu cha kusankhidwa ndi matenda a shuga a 2. Vildagliptin imafotokozedwa ngati chithandizo chachikulu, magawo awiri othandizira (pogwiritsa ntchito mankhwala ena), mankhwala othandizira atatu (pogwiritsa ntchito mankhwala awiri).
Poyamba, chithandizo chimachitika limodzi ndi masewera olimbitsa thupi komanso zakudya zosankhidwa mwapadera. Ngati monotherapy singagwire ntchito, zovuta zimagwiritsidwa ntchito limodzi ndi mitundu yotsatirayi: sulfonylurea derivatives, thiazolidinedione, metformin, insulin.
Zina mwazoyipa:
- tsankho mankhwala;
- aimpso kuwonongeka;
- mimba
- kuchepa kwa lactase;
- chiwindi ntchito;
- anthu ochepera zaka 18;
- kulephera kwa mtima;
- nthawi ya mkaka wa m`mawere;
- galactose tsankho.
Malangizo ogwiritsira ntchito
Mapiritsi amatengedwa pakamwa popanda kutanthauza chakudya. Mlingo wothandizila umatsimikiziridwa ndi dokotala, poganizira momwe wodwalayo alili komanso kulolera kwa mankhwalawo.
Mlingo woyenera ndi 50-100 mg. Woopsa 2 mtundu wa shuga, mankhwalawa mankhwala 100 mg tsiku. Kuphatikiza ndimankhwala ena (munthawi ya chithandizo cha magawo awiri), kudya tsiku lililonse ndi 50 mg (piritsi 1). Ndi osakwanira panthawi yovuta mankhwala, mlingo umakulitsa mpaka 100 mg.
Palibe chidziwitso chokwanira chogwiritsira ntchito mankhwalawa panthawi yapakati komanso mkaka wa m`mawere. Chifukwa chake, gawo ili ndilosafunika kumwa mankhwala omwe aperekedwa. Mosamala kwambiri ayenera kumwedwa odwala matenda a chiwindi / impso.
Anthu osakwana zaka 18 sayenera kugwiritsa ntchito mankhwalawa. Siwabwino kuyendetsa magalimoto mumamwa mankhwalawo.
Pogwiritsa ntchito vildagliptin, kuwonjezeka kwa ziwindi za chiwindi kungawonedwe. Panthawi yayitali chithandizo, tikulimbikitsidwa kuwunika mozama momwe zinthu zikuyendera ndikusintha kwamankhwala.
Ndi kuwonjezeka kwa aminotransferases, ndikofunikira kuyesanso magazi. Ngati Zizindikiro ziwonjezereka nthawi zopitilira 3, mankhwalawo amayimitsidwa.
Zotsatira zoyipa ndi bongo
Mwa zina zomwe zingachitike ndi zovuta:
- asthenia;
- kunjenjemera, chizungulire, kufooka, mutu;
- kusanza, kusanza, kuwonetsa Reflux esophagitis, flatulence;
- zotumphukira edema;
- kapamba
- kulemera;
- hepatitis;
- pruritus, urticaria;
- Matenda enanso ambiri.
Mankhwalawa amaloledwa ndi odwala, mlingo wovomerezeka watsiku ndi tsiku umafika mpaka 200 mg patsiku. Mukamagwiritsa ntchito zoposa 400 ml, izi zitha kuchitika: kutentha, kutupa, kuchuluka kwa malekezero, nseru, kukomoka. Ngati zizindikiro zikuchitika, ndikofunikira kutsuka m'mimba ndikupempha thandizo kuchipatala.
N`zothekanso kuwonjezera C-yotakasika mapuloteni, myoglobin, creatine phosphokinase. Angioedema nthawi zambiri imawonedwa ikaphatikizidwa ndi ACE inhibitors. Ndi kusiya kwa mankhwalawa, mavuto amatha.
Kuyanjana Ndi Mankhwala Ndi Analogi
Kuthekera kwa mgwirizano wa vildagliptin ndi mankhwala ena ndizochepa. Kuyankha kwa mankhwala omwe amagwiritsidwa ntchito kawirikawiri pochiza matenda a shuga a mtundu wa 2 (Metformin, Pioglitazone ndi ena) ndi mankhwala ocheperako (Amlodipine, Simvastatin) sanakhazikitsidwe.
Mankhwala amatha kukhala ndi dzina lamalonda kapena dzina lomweli ndi chinthu chogwira ntchito. M'mafakitare mungapeze Vildagliptin, Galvus. Pokhudzana ndi contraindication, dokotala amatipatsa mankhwala ofananawa omwe amawonetsa zofanananso zochizira.
Mafuta a mankhwalawa akuphatikizapo:
- Onglisa (saxagliptin yogwira pophika);
- Januvia (chinthu - sitagliptin);
- Trazenta (chigawo chimodzi - linagliptin).
Mtengo wa Vildagliptin umachokera ku ma ruble 760 mpaka 880, kutengera malire apaderako.
Mankhwalawa azikhala pa kutentha osachepera madigiri 25 m'malo owuma.
Maganizo a akatswiri ndi odwala
Malingaliro a akatswiri ndi kuwunika kwa odwala pamankhwala ake ndiabwino.
Poyerekeza ndi momwe amamwa mankhwalawa odwala omwe ali ndi matenda a shuga a 2, zotsatirazi zimadziwika:
- kuchepa msanga kwa shuga;
- kukonza chizindikiro chovomerezeka;
- ntchito mosavuta;
- Kulemera kwa thupi panthawi ya monotherapy kumakhalabe chimodzimodzi;
- mankhwala limodzi ndi antihypertensive kwenikweni;
- zoyipa zimachitika kawirikawiri;
- kusowa kwa zochitika za hypoglycemic pomwa mankhwalawa;
- matenda a lipid kagayidwe;
- mulingo wabwino wa chitetezo;
- kusintha kagayidwe kazakudya;
- yabwino kwa odwala ambiri omwe ali ndi matenda a shuga a mtundu wachiwiri.
Vildagliptin m'kafukufukuyu yatsimikizira kuti ntchitoyi ndi yofunika komanso yolekerera zabwino. Malinga ndi chithunzi cha chipatala ndi zizindikiro zowunikira, palibe milandu ya hypoglycemia yomwe idawonedwa panthawi ya mankhwala.
Vildagliptin imadziwika kuti ndi mankhwala othandizira a hypoglycemic, omwe amaperekedwa kwa mtundu wachiwiri wa odwala matenda ashuga. Imaphatikizidwa mu Medicines Register (RLS). Amawerengedwa ngati monotherapy komanso kuphatikiza ndi othandizira ena. Kutengera ndi matendawa, kuthandizira kwake, mankhwalawa amatha kuthandizidwa ndi Metmorphine, zotumphukira za sulfonylurea, insulin. Dokotala wothandizirayo akupereka mankhwala molondola ndi kuwunika wodwalayo. Nthawi zambiri odwala omwe ali ndi matenda a shuga a 2 amakhala ndi matenda ofanana. Izi zimasokoneza kwambiri kusankha kwa mankhwala ochepetsa mphamvu ya shuga. Zikatero, insulin ndiyo njira yachilengedwe kwambiri yotsitsira shuga. Kudya kwake mopitirira muyeso kumatha kuyambitsa hypoglycemia, kuwonda. Pambuyo pa phunziroli, zidapezeka kuti kugwiritsa ntchito Vildagliptin limodzi ndi insulin kumatha kupeza zotsatira zabwino. Chiwopsezo chotenga matenda a mtima, hypoglycemia imachepetsedwa, lipid ndi carbohydrate metabolism imapangidwa bwino popanda kulemera.
Frolova N. M., endocrinologist, dokotala wamtundu wapamwamba kwambiri
Ndakhala ndikutenga Vildagliptin kwazaka zopitilira, adandiuza ngati dokotala wophatikiza ndi Metformin. Ndinkada nkhawa kwambiri kuti nthawi yayitali kwambiri ndikalandira chithandizo chamankhwala. Koma adachira ndimakolo asanu okha mpaka 85 yanga. Mwa zovuta zina, ndimakonda kudzimbidwa komanso kusanza. Pazonse, chithandizo chamankhwala chimapatsa zotsatira zomwe zimafunikira ndipo chimadutsa popanda zovuta.
Olga, wazaka 44, Saratov
Zolemba za Dr. Malysheva pazogulitsa zomwe zingagwiritsidwe ntchito ngati kuwonjezera mankhwala osokoneza bongo:
Vildagliptin ndi mankhwala othandiza omwe amachepetsa shuga komanso kusintha ntchito ya pancreatic. Ithandizanso odwala omwe sangathe kuphatikiza shuga pochita masewera olimbitsa thupi ndi zakudya zapadera.
